Indiana Health IT Blog

The proof of the benefits of e-prescribing is undeniable and growing daily. When a basic CPOE (computerized physician order entry) is used, it reduces the odds of medication errors by 70%. ⁽¹⁾ To date, the estimated savings from preventing adverse drug events alone totaled $4.64 billion. ⁽²⁾

The following data was acquired by ONC from Surescripts, the nation's leading e-prescription network.

• There are currently 8,271 total e-prescribers in the State of Indiana which is an increase of 480 in just 3 months.
• 47.1% of office-based Indiana physicians sent an electronic prescription via Surescripts while the national average is 43%.
• There are currently 74% of e-prescribers in Indiana that send more than 20 e-prescriptions monthly while nationally, the number is 71%. We hope to see this number grow both nationally and statewide in the near future.
• Tracking the distribution of new prescriptions and renewal requests on the Surescripts network is a useful way to assess the robustness of HIE. Renewal requests are more complicated than new because it is a two-way transaction (pharmacist must identify and locate the original prescriber) whereas a new prescription is a one-way process. 84% of prescriptions in the State are new while 16% are renewal.

For more information click on the link to take you directly to their website.

Surescripts

Agency for Healthcare Research and Quality (AHRQ)

ONC

(1) Devine et. al (2010)

(2) Center for IT Leadership (2010)

In the ONC's December 21st announcement, this new system of records will be used by the ONC and its partners to assess, evaluate, improve and publicize the effectiveness of ONC health IT grants to States and State-designated entities.

The datasets will enable the ONC to assess how well the grantees are doing compared to each other. The 62 regional health IT extension centers can also validate their progress reports and track performance improvements so they can receive payments.

ONC intends to collect data about physicians' health IT implementation, demographics and contact information from their National Provider Identifier (NPI).

“ONC partners and ONC grantees will only have access to data specifically pertaining to the achievement of that entity’s grant or contract purpose,” ONC said in its notice.

The system will not contain information about patients, ONC assured.

To read the ONC Action in its entirety, click here.

EHR enabled medical practices report that they are experiencing improved medical practice management through integrated scheduling systems that link appointments directly to progress notes, automate coding and managed claims.

They are saving time (which equals money) because of easier centralized chart management, condition-specific queries and many other shortcuts.

They have better communication with other clinicians, labs and health plans because there is

• easy access to patient information from anywhere
• tracking electronic messages to staff, other clinicians, hospitals, labs and more
• automated formulary checks by health plans
• order and retrieve lab results easily as well as diagnostic images
• links to public health systems such as registries and communicable disease database

Because there is an increase of accuracy in coding, this leads to an average of $26 per patient visit of billable gains! There increased patient flow and staff productivity which results in increased revenue.

Electronic health records reduce paperwork overall. Administrative tasks, such as filling out forms and processing billing requests, represent a significant percentage of health care costs. EHR's increase practice efficiencies by streamlining these tasks which significantly decrease costs.

In addition, EHR's can deliver more information in additional directions. They can be programmed for easy or even automatic delivery of information that needs to be shared with public health agencies or for the purpose of quality measurement.

Because EHR's contain all of the patient's health information in one place, it is less likely that providers will have to spend time ordering, and reviewing the results of unnecessary or duplicate tests and medical procedures. Bottom line, less utilization means fewer costs.

Few doubt the benefits of implementing an EHR, but can confused on where to turn for help.

After speaking with several providers over recent weeks, it is obvious there is still much confusion about the basics of EHRs, where to turn to for incentive funds and the complexities of meaningful use.

Even though Indiana is at the forefront of the Health Information Technology, there is a severe shortage of skilled healthcare and IT professionals able to understand, apply and manage these emerging technologies.

As we blogged earlier, Ivy Tech has recently begun to offer classes in EMR implementation and optimization. These classes will help bridge the gap between healthcare and information technology.

The Indiana Health Information Technology Training Collaborative (I-HITTC) is a collaboration between IUPUI School of Informatics, IU School of Medicine, and the Regenstrief Institute. This program is funded through the Office of National Coordinator for health information technologies program of assistance for university-based training.

I-HITTC has developed and deployed the following IT training programs:

• Certificate in Clinical Informatics
• Certificate in Informatics for Public Health Professionals
• Certificate in Informatics in Health Management and Exchange
• Certificate in Informatics in Health Information Security
• Certificate in Informatics in Health Information Systems Architecture
• Master of Science in Clinical Research

Students also have the choice to work in the field for hands-on experience such as St. Francis Hospital, IU Health North, IU Health Methodist, or in an operational HIE.

For more information on the following, click on their name;

Office of National Coordinator

Ivy Tech

IU Certificate and Degree Programs in HIT

Electronically prescribing controlled substances has been a long awaited function because it should actually cut prescription forgery levels by helping pharmacists and DEA officials to more easly trace controlled substance scripts to legitimate prescribers. They can also make sure that the meds get dispensed by the intended pharmacist and received by the intended patient. Of course, e-prescribing these scripts would also have the benefit of avoiding illegibly-written orders, as it does for non-controlled drugs.

Surescripts announced recently that it has upgraded its nationwide network to support electronic prescribing of controlled substances (EPCS). For this initial operation, Surescripts is actively monitoring the end-to-end characteristics of EPCS usage, such as physician credentialing, workflows, processing times and quality. When they complete this preliminary monitoring, which is planned to end later this year, Surescripts will make EPCS support available to all certified participants.

In order to electronically prescribe controlled substances, some of the major DEA requirements prescribers must adhere to include:

• Use of an e-prescribing application that is certified for this purpose.
• Completion of a compliant identity-proof process.
• Use of a secure, two-factor authentication process to sign prescriptions for controlled substances.

This is a great step in the right direction for eHealth. For more information, visit Surescripts website.

Indiana FSSA announced last week that a St. Joseph County hospital has received a substantial incentive payment for meeting federal requirements for electronic recordkeeping.

IRHA (Indiana Rural Health Association) announced earlier this week they have been awarded federal funding to create the Upper Midwest Telehealth Resource Center.

This is great news for patients who wish to be more involved in their own healthcare. Up until now, patients had to receive their test results through the ordering provider.

MHIN (Michiana Health Information Network) Located in South Bend Indiana has achieved accreditation this week by EHNAC (Electronic Healthcare Network Accreditation Commission). EHNAC evaluates Health Information Exchanges in the areas of privacy and security, technical performance, business practices and organizational resources as it relates to HIE policies and procedures.

MHIN either meets or exceeds all EHNAC criteria and industry standards. This does not come as a big surprise as MHIN is one of the most mature and robust HIEs in the country.

"With so much developing and changing still in the HIE industry, it is important for our regional providers and communities to recognize and understand that MHIN is taking every necessary measure to ensure that we are handling their secure medical information with the most advanced technology and service available," stated Tom Liddell, Executive Director of MHIN. "EHNAC HIEAP accreditation reinforces our dedication to serve our region and continue to be a leader in the industry."

For more information about MHIN, their history, services provided, mission and solutions offered, click here or call (574) 968-1004.

Meet e-Patient Dave, a man full of energy and with a new found calling for helping other patients.

It is very exciting in the IT world when someone comes up with a great idea. BluePrint Health IT has done just that with their Innovation Summit Series coming to Indianapolis in September of this year.

The vision of the BluePrint Health IT Innovation Summit Series is to accelerate and optimize patient care capabilities for providers, users and consumers of health information technology by showcasing and fostering innovation through a national platform for education and collaboration which matches Providers with Health IT Innovators.

What better way to do this than to replicate the methodology used in the speed dating arena? This is how it works, 10 healthcare technology companies and 10 healthcare providers will come together and meet for about 10 minutes each in order for the technology companies to present their innovative ideas to the providers and allow the providers to ask questions.

Applications are being accepted now for Health IT Innovators, Hospitals and Sponsors. The deadline is August 19, 2011. Click here to register.

John Kansky VP of product management of IHIE has just joined the BluePrint advisory board.

This status is granted to vendors with software products that have exceeded Surescripts baseline product certification.

The HIE connectivity program focuses on rural communities and underserved populations. In order to close the gap in connectivity among rural hospitals, community health centers, laboratories and radiology centers, IHIT SHIE (State Health Information Exchange)-CAP (Cooperative Agreement Program) connectivity program's goal is to provide the following:

• 30 critical access and sole community hospitals that are not currently connected to a HIO (Health Information Organization) with incentives up to $40,000 to help offset costs in connecting to a HIO of their choice.

• 100 community health centers that are not currently connected to a HIO, each with a expense reimbursement up to $10,000 to put toward interface costs with a HIO.

• 50 independent laboratories and radiology centers that are not currently connected to a HIO with incentive payments up to $10,000 per entity to put towards interfacing with a HIO of their choice. IHIT will provide incentives for up to 30 laboratories (3 per congressional district and 3 at large). There are 20 slots available for Radiology centers (2 per congressional district and 2 at large).

As you can see from the graph, to date, there are 28 places filled of the 30 available for critical access and sole community hospitals. 56 slots are taken of the 100 slots available for CHC/RHC and FQHC's. None of the 30 lab spots have been filled and 2 of the 20 radiology slots have been taken.

Private Health Information Exchanges are growing exponentially compared to the public HIE's

Is buying the EMR solution for your practice on the same shopping trip as picking up your mega sized paper towels an ingenious plan or a sensless trend?

E-Prescribing is growing rapidly, but is it enough?

Will the possible delay of Stage 2 Meaningful use help or hinder the EMR implementation?