D.C Report: CMS Releases Attestation Updates, EHR Usability, Secondary Data Usage

CMS Releases Attestation Updates; Incentive Payments Top $870M The Centers for Medicare and Medicaid Services (CMS) released registration and payment totals (.pdf) for Meaningful Use Incentive Payments this week. The totals, tallied through September, indicated that $872 million for both Medicare and Medicaid have been awarded to successful attesters for Meaningful Use Stage 1 objectives. Registrations for the month of September peaked at nearly 24,000 eligible professionals and eligible hospitals, bringing total active registrants to 114,644. Other highlights of totals through September include:

• 158 hospitals have attested to Meaningful Use under Medicare
• 59 hospitals have received payments under both Medicare and Medicaid.
• 2,215 hospitals have registered to attest
• 33 states have launched Medicaid EHR programs launched Medicaid EHR programs
• Texas is leading the pack at $198,530,907 in Medicare and Medicaid payments, but mainly because of the amount sent out for Medicaid
• Michigan is the top state for Medicare payments at $50,560,942

Check out where your state ranks.

NIST Draft Guidance Looks at EHR Usability Late last week the National Institute of Science & Technology (NIST) released draft guidance (.pdf) on the usability of electronic health records. The guidance is part of the NIST health IT Usability initiative, which is focused on establishing a framework that defines and assesses health IT usability. The goal of the research effort is to create a detailed specification of an objective, repeatable procedure for measuring and evaluating the usability of health IT systems. The draft document summarizes the rationale for an Electronic Health Record (EHR) Usability Protocol (EUP) that encompasses procedures for (1) expert evaluation of an EHR user interface from a clinical perspective and a human factors best practices perspective, and (2) validation studies of EHR user interfaces with representative user groups on realistic EHR tasks. The document presented for public comment uses a three-step process—that incorporates both the evaluation and validation procedures—for design evaluation and human user performance testing for an EHR. This process is focused on increasing safe use of the EHR and increasing ease of use of the EHR by users. The steps are as follows:

• Usability/Human Factors Analysis of the application during EHR user interface development;
• Expert Review/Analysis of the EHR user interface after it is designed/developed; and
• Testing of the EHR user interface with users.

The draft guidance will be open for comment until November 10, 2011.


Health IT Policy Committee Looks at ‘Secondary Use’ of Data The Health IT Policy Committee (HITPC) met this week and discussed draft recommendations to an advanced notice of proposed rule making that would update regulations protecting human research subjects, including rules guiding data security for the subjects' personal information. According to the Policy Committee, use of EHR data for treatment purposes or to evaluate safety, quality and effectiveness of care should not require patient consent, institutional review board approval or registration. The HITPC said the Department of Health and Human Services “could take the approach of not labeling these activities as ‘research’ but instead should consider them to be treatment or operations if conducted by, or on behalf of (such as by a business association), a provider entity.” Additional recommendations outlined activities that should be covered under its recommendations, including:

• Use of data to improve patient care, such as evaluating care effectiveness;
• Identification of patterns of adverse events;
• Evaluation of interventions aimed at improving care quality;
• Monitoring performance of individual clinical and professional staff; and
• Outreach efforts to boost patient compliance with existing standards

Check out a copy of the draft transmittal letter