Archive for the ‘Electronic Health Records’ Category
Under a recent agreement with the American Medical Association (AMA), the National Library of Medicine (NLM) will be including the AMA’s Current Procedural Terminology (CPT) codes for molecular pathology tests in the National Institutes of Health’s Genetic Testing Registry (GTR). GTR is operated by NLM’s National Center for Biotechnology Information (NCBI), and provides a resource for comprehensive information about genetic tests. The database provides a central location for voluntary submission of test information by providers. Content includes the test’s purpose, methodology, validity, evidence of the test’s usefulness, and laboratory contacts and credentials.
Under the new agreement, AMA’s CPT codes for molecular pathology tests will be integrated into GTR. The AMA-created codes describe the latest advances in genetic testing and molecular diagnostic services for reporting and tracking purposes. AMA’s new, more detailed CPT codes for molecular pathology became effective in 2012. Inclusion of the CPT codes in GTR further enhances the database’s interoperability with electronic medical records and laboratory information management systems. GTR also incorporates SNOMED CT (Systematized Nomenclature of Medicine – Clinical Terms), an extensive clinical terminology produced by the International Health Terminology Standards Development Organisation (IHTSDO), and LOINC (Logical Observation Identifiers Names and Codes), produced by the Regenstrief Institute, which provides standardized terms and codes for identifying laboratory and clinical observations. NLM is the US Member of the IHTSDO and provides support for the development and free US-wide use of both SNOMED CT and LOINC. CPT, SNOMED CT, and LOINC are required standards in the certification criteria for electronic health record products issued by the Office of the National Coordinator for Health Information Technology, Department of Health and Human Services.
The National Library of Medicine, in collaboration with the Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare & Medicaid Services (CMS), has launched the NLM Value Set Authority Center (VSAC). The VSAC provides downloadable access to all official versions of vocabulary value sets contained in the 2014 Clinical Quality Measures. The value sets provide lists of the numerical values and individual names from standard vocabularies used to define the clinical concepts, e.g., diabetes or clinical visit, used in the quality measures. The content of the VSAC will gradually expand to incorporate value sets for other use cases, as well as for new measures and updates to existing measures. Access to the Value Set Authority Center requires a free Unified Medical Language System Metathesaurus License. NLM also provides the Data Element Catalog that identifies data element names (value set names) required for capture in Electronic Health Record (EHR) technology, certified under the 2014 Edition of the ONC Standards and Certification Criteria.
The Guide for Reading Eligible Professional and Eligible Hospital 2014 eCQMs, published by CMS, provides guidance for understanding and using the electronically specified eligible professional (EP) and eligible hospital (EH) clinical quality measures (“eMeasures”). CMS has also provided the following release notes with updated program requirements related to the eCQMs, and global changes incorporated across all measures, as well as specific changes to the measures retained in the 2014 eCQMs; Clinical Quality Measures for CMS’s 2014 EHR Incentive Program for Eligible Professionals and Clinical Quality Measures for CMS’s 2014 EHR Incentive Program for Eligible Hospitals. CMS has also published the 2014 Clinical Quality Measures Tipsheet, which includes an overview of the CQMs, including the number of measures eligible professionals (EPs) and eligible hospitals (EHs) must report, CQM reporting options, and reporting and submission periods. For questions about these resources, contact the NLM Value Set Authority Center Help site.
The National Library of Medicine recently released two enhancements to MedlinePlus Connect. MedlinePlus Connect now returns responses for medication information in Spanish. Also, the MedlinePlus Connect Web service delivers more targeted information when responding to medication information requests. In September 2012, NLM enhanced the MedlinePlus Connect Web service response for medication code requests. Previously, the MedlinePlus Connect Web service returned a link to a search results page with the best matches from the MedlinePlus drug information. Now, the enhanced Web service returns direct links to relevant drug information pages on MedlinePlus.
Starting in October 2012, MedlinePlus Connect returns requests for medication information in Spanish. This complements MedlinePlus Connect’s responses for diagnosis and lab test information, which were already available in both English and Spanish. MedlinePlus Connect processes requests for Spanish medication information differently from requests for English medication information. For Spanish medication information, MedlinePlus Connect responds only to National Drug Codes (NDCs) or RxNorm Concept Unique Identifier (RXCUIs). It does not use text strings, which are accepted for requests for English medication information. It is possible to have a response in English and not in Spanish.
MedlinePlus Connect is NLM’s service for patient portals and electronic health record (EHR) systems, to link to patient-friendly and context-relevant information from MedlinePlus. It responds to code-based requests, and delivers information for patients that relates to a specific diagnosis, medication or lab test. Full details on sending requests for medication information, either to the MedlinePlus Connect Web service or the Web application are available on the technical information page.
In November, 2010, the federal Office of the National Coordinator for Health Information Technology (ONC) convened the Southeast Regional HIT-HIE Collaboration (SERCH) project on Health Information Exchange in Disaster Preparedness and Response. The consortium included representatives from Alabama, Arkansas, Florida, Georgia, Louisiana, and Texas, with the goal of developing a strategic plan for sharing health information data among the Southeast and Gulf States during and following a declared natural disaster. The consortium members carefully assessed the challenges of accessing medical records and coordinating health care information for patient populations displaced due to a disaster. To date, there has been limited research on how HIE could be leveraged to provide timely access to clinical information in response to a disaster. The best way to ensure that health information can be accessed during an emergency is to ensure that it can be accessed during routine care. As connectivity through HIE expands, opportunities to link exchange efforts with emergency preparedness and response to provide health information to providers and patients in response to a disaster will increase.
The final report from the project, released in July, 2012, includes an actionable plan for incorporating health information exchange into disaster preparedness efforts. The phased approached suggested by SERCH supports immediate progress in the absence of routine, widespread health information exchange. It also addresses key legal, technical, and governance issues and offers a list of steps that states can take to align their health information exchange planning activities with ongoing emergency preparedness activities. The report includes five recommendations, which offer a path forward for states wishing to integrate disaster planning and health information exchange efforts, to help ensure that when a disaster strikes, patients and providers will have better access to information, and providers will be better able to provide appropriate care.
Data dashboards provide a mechanism to use visualization, rather than words, to get a quick overview of progress made towards programmatic goals, and to engage stakeholders in the evaluation process. To use data dashboards effectively, it is important to define the user group(s) involved and to select recognizable metrics from trusted sources. There are a variety of resources available to assist with producing dashboards for web sites, blogs, etc., including Juice Analytics, Tableau Software, and Google Analytics. After registering with Juice Analytics, one resource to consider is a white paper listed in the “Visualization Resources” category, called A Guide to Creating Dashboards People Love to Use. Once established, data dashboards can monitor the progress of a program, communicate progress to stakeholders, and provide early signs of problems that may be arising.
To get an idea of a final product, a good example to view is the Health IT Dashboard showing the implementation of the Regional Extension Center (REC) Cooperative Agreement Program, coordinated by the federal Office of the National Coordinator for Health IT (ONC). The REC program is funded to provide technical assistance for EHR implementation to 100,000 primary care providers, through 62 nationwide sites. The dashboard charts the enrollment of primary care providers in this program, and monitors their efforts to become meaningful users of electronic health records (EHRs). Dashboards could be a colorful, visual way for you to show what you do to benefit the overall institution!
This week, the Office of the National Coordinator (ONC) added a number of resources to HealthIT.gov. Highlights include:
Stage 2 Meaningful Use—Final Rules: On Thursday, August 23, ONC and The Centers for Medicare & Medicaid Services (CMS) released final requirements for the Stage 2 Electronic Health Records Incentive programs and Standards & Certification Criteria. Information and resources about both rules are available on a new Meaningful Use Stage 2 page.
New Consumer Videos Available: In recent weeks, ONC has expanded its library of consumer-friendly videos. New videos available in the Patients and Families section of HealthIT.gov include an animated video about the benefits of health IT, as well as winners of two consumer video challenges. Watch the videos.
Redesigned Federal Advisory Committee (FACA) Pages Launched: Webpages for the Health IT Policy and Standards committees and workgroups meetings featuring a new meeting calendar are now available. Visit the new FACA pages to view calendars and other resources for both the Health IT Policy Committee and the Health IT Standards Committee.
Read the Buzz from Your Mobile Device: ONC launched its Health IT Buzz blog mobile website. Readers can now access information about health IT and view important updates from ONC from their smartphone or other mobile devices. Read the Health IT Buzz blog.
Remember to visit the HealthIT.gov web site often for the latest information and resources, and to stay up-to-date on how health IT is improving America’s health and health care!
MyMedList (MML) has been released as a free Apple iOS app on the NLM Gallery of Mobile Apps and Sites. MML, developed by the National Library of Medicine, is designed to maintain a record of an individual’s current and past medications, which is easily accessible and adequately protected. MyMedList allows users to electronically manage their medication list(s), and control access to their personal information. The medication list can be printed out to share, mailed to a relative, serve as a reminder to the individual for taking medications, or be shown as reference information in doctors’ offices or hospitals. The app is based on standards; MML follows the HL7 standard for CDA/CCD and uses RxNorm data for prescription medications.
Edit: MyMedList is no longer being actively maintained and was removed from the iTunes. (1/13/14 LT)
The National Library of Medicine provides free access to vocabulary standards, applications, and related tools that can be used to meet US EHR certification criteria and to achieve Meaningful Use of EHRs. MedlinePlus Connect, RxNorm, SNOMED CT, and LOINC are resources either created by or supported by NLM that can be used for providing patient-specific education materials, e-prescribing, and creating, exchanging, and interpreting standardized lists of problems, medications, and test results. For additional information, please visit the NLM Tools for EHR Certification and Meaningful Use webpage.
In a new press release from the Centers for Medicare & Medicaid Services (CMS), HHS Secretary Kathleen Sebelius announced a proposed rule that would delay the compliance date for ICD-10 from October 1, 2013 to October 1, 2014. The ICD-10 compliance date change and proposed rule would adopt a standard for a unique health plan identifier (HPID), adopt a data element that would serve as an “other entity” identifier (OEID), and add a National Provider Identifier (NPI) requirement. The proposed rule was developed by the Office of E-Health Standards and Services (OESS) as part of its ongoing role, delegated by HHS, to establish standards for electronic health care transactions under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Additional details about the proposed rule may be found on the CMS ICD-10 fact sheet.
The proposed changes would save the health care industry up to $4.6 billion over ten years by enabling greater automation of electronic health care transactions, in turn helping physicians spend less time interacting with health plans, and more time with patients. The proposed rule would implement several administrative simplification provisions of the Affordable Care Act. The proposed rule also would delay by one year, until Oct. 1, 2014, the date by which covered entities must comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10). Covered entities are defined in HIPAA as (1) health plans, (2) health care clearinghouses, and (3) health care providers who electronically transmit any health information in connection with a transaction for which HHS has adopted a standard.
Some provider groups have expressed serious concerns about their ability to meet the October 1, 2013 compliance date. CMS and HHS believe the change in the compliance date for ICD-10, as proposed in this rule, would give providers and other covered entities more time to prepare and fully test their systems to ensure a smooth and coordinated transition among all industry segments. Please visit the ICD-10 web site for the latest news and resources to help you prepare for a smooth transition!
The Notice of Proposed Rulemaking (NPRM) for Stage 2 meaningful use was posted to the Office of the Federal Register today. The proposed rule outlines the next stage of meaningful use for the Electronic Health Record (EHR) Incentive Programs, administered by the Centers for Medicare & Medicaid Services (CMS). CMS has developed a fact sheet to give providers an overview of the rule and how Stage 2 expands upon Stage 1 of meaningful use. Additional information about meaningful use is available on the CMS EHR Meaningful Use Overview web page.