For many years now, HIMSS has championed the best use of information technology and management systems for the betterment of healthcare.  Since the inception of the HITECH provisions of the American Recovery and Reinvestment Act of 2009 (ARRA), HIMSS has equipped stakeholders for increasingly sophisticated meaningful use of health information. To help providers and patients improve care delivery and health outcomes for all Americans, HIMSS members strongly encourage the federal government to continue promoting the adoption of EHRs through the Medicare and Medicaid EHR Incentive Program in support of the standards-based collection, analysis, and exchange of health data in a safe and secure environment. 

The release of these regulations during the 2012 Annual HIMSS Conference & Exhibition gives attendees the opportunity to engage directly with CMS and ONC officials about the new rule. Both CMS and ONC have hosted interactive town hall sessions, and more than 80 HIMSS12 workshops, symposia, and general education sessions have focused on meaningful use. 

Using social media and HIMSS.org, HIMSS staff have been posting – within hours – key takeaways from policymakers’ remarks.  HIMSS will be reviewing the proposed rule and posting summaries and analyses in the coming days.  Stay tuned to HIMSS’ Meaningful Use OneSource, where we expect to post substantive analyses beginning next week. 

The Medicare and Medicaid EHR Incentive Programs have already had an enormous impact on EHR adoption rates. Forty-three states have started their Medicaid EHR Incentive Programs; over 190,000 Eligible Professionals (EPs) and Eligible Hospitals (EHs) have registered for the Medicare and/or Medicaid EHR Incentive Programs; and more than $3 billion has been paid in incentive payments to EPs, EHs, and critical access hospitals (CAHs) across the country. 

New HIMSS Analytics data, reported in the December 2011 Summary of Meaningful Use Readiness, indicates that seven segments of hospitals show increased capability to achieve Stage 1 of meaningful use. The hospitals in these seven categories typically demonstrate IT adoption that outpaces their peers, a segment that also includes hospitals at Stage 6 or Stage 7 on the HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM). Tremendous progress has been made toward improved patient care and efficiencies offered by health IT, and HIMSS is excited to work with our members to move into this next phase of transforming healthcare.

To give providers and vendors adequate time to meet the new requirements, release of the proposed regulations at this juncture meets a recommendation of HIMSS and other organizations that the final rule be released at least 18 months prior to enactment.

HIMSS looks forward to engaging our members and colleagues in the development of HIMSS Board of Directors-approved responses to the proposed regulations that provide practical, real world observations and recommendations.

http://www.ofr.gov/OFRUpload/OFRData/2012-04443_PI.pdf

PROPOSED RULES

Medicare and Medicaid Programs:

Electronic Health Record Incentive Program -Stage 2

 2012-04443
[CMS-0044-P; Filed: 02/23/12 at 4:15pm;  Publication Date: 3/7/2012]

Watch the HIMSS website at www.himss.org  and Twitter for updates from HIMSS.  The HIMSS Blog will update readers as well.

To ensure the quality improvements and costs savings to the nation as a whole, access to health information technology is necessary for all Americans including,

• minorities,
• inner city residents,
• rural, and
• other historically underserved populations. 

Current efforts for access to health information technology, such as the necessary resources, cultural and linguistic sensitivity, and health literacy, may not be meeting the mark.      

With this issue in mind, I am looking forward to attending a “panel-based, brown bag” lunch meeting, during the HIMSS12 conference. Here are the details.

Tuesday February 21                                                                                                                 Noon -2 p.m.                                                                                                                                Toscana 3609                                                                                                                             Venetian Sands Expo Center 

At this session, you will hear industry experts, from “diverse” business environments and populations, who are  committed to the integration and implementation of information technology to help reduce health disparities and support workforce development on a national level.

This discussion will attempt to focus on the approaches and resources necessary to ensure this population receives the full advantage of healthcare transformation in America.

You don’t need to register in advance for this session…so please join me on Tuesday, Feb. 21, from  noon- 2 -p.m.   

My assumptions were that both my “CIO” and I were attending HIMSS: he would attend senior executive sessions, and I would attend those sessions that would help our organization not only maximize our pursuit of meaningful use dollars, but also, help us to sustain our investments in the clinical, business, and administrative aspects of our technology, our processes, and our people.  And, I would be on the lookout for other sessions that would help us with our other challenges as well: ICD-10 implementation, medical home, improving our processes, excelling at providing exceptional clinical experiences, etc.  I think you get my intent.

Why would I assume this fictitious role and share my experiences? 

Because many of you, including the media, ask me my opinion every year on those “not to be missed” sessions.  So I thought I would comply. 

But I couldn’t do it.  Not this year.  I became conflicted. 

There is  so much great education across our pre-conference, general education, and exhibition floor venues that I just could not decide to help you, our attendees, understand what interests me.  And this is a testament to those of you who answer the call for participation; those of you who serve as peer reviewers; and the members of the Annual Conference Education Committee who work extremely hard to make sure that HIMSS presents a compelling line-up of education to meet and exceed the demands of health IT professionals everywhere.  And, of course, those of you who attend our sessions and share your experiences  through our evaluation mechanisms.

And on behalf of HIMSS, I thank  you.  HIMSS staff, from our Meeting Services Department, to Corporate Relations, to Professional Development, our Executives, the Government Relations teams, and many others who work extremely hard to ensure that we offer you the best possible experience. 

And this year, we have various improvements planned for you that will enhance your experience. 

For the first time, what “happens in Vegas does not need to stay in Vegas,” since we’ve added the Virtual HIMSS12 conference that continues to accept registrations through April 21, 2012.  And it’s designed for those who “just can’t get to HIMSS’…like those who are back in the organization making sure that the CIO and others can attend HIMSS.

So, maybe next year I’ll provide you with my top “not to be missed” sessions.  Stay tuned.

 And enjoy the show!

• It’s a chance to meet and network with other first-time Conference attendees
• There will be a live Q&A opportunity to ask @HIMSS folks your pressing Conference questions
• If folks are interested, there’ll be the opportunity for an in-person Tweet-up for first time attendees at the Conference in Vegas

Now that you’re thoroughly convinced, you’ll just need to log into Twitter tomorrow, at 12 noon ET, and follow the @HIMSS Twitter handle using the #1stHIMSS hashtag. 

If you have any questions about participating please e-mail HIMSS@shiftcomm.com.

Happy tweeting, newbies!

The evidence seems to be everywhere.

I recently participated in the first HIMSS Nursing Informatics Institute, hosted by Sharp HealthCare in San Diego. The local response to this event was amazing, and due to space limitations, we had to close registration at 200 people.  Within a few weeks, we had a waiting list of 90 people hoping to attend.

When planning the event, our primary goal was for Institute participants to:

• build on their portfolio of skills around career development, and
• understand their roles in implementing information technology to enhance nursing workflow, promote patient safety, and yield outcomes that improve patient care.

We also wanted to connect participants with the major initiatives and activities impacting the nursing profession today—giving them insight on how to shape the healthcare of tomorrow. When I polled the audience at the beginning of the day, about 10% identified themselves as informatics nurses.

But it became evident from our dialogue throughout the day that the majority of attendees were highly interested in the specialty of nursing informatics, and wanted information about related educational programs, career advancement and certification opportunities. In several cases, participants were already working in an informatics role, but didn’t even realize it.

Flash forward to this past week when I suddenly started getting requests for help from registrants for the HIMSS12 Nursing Informatics Symposium, which will be held on Feb. 19-20 in Las Vegas. Potential registrants learned the event had sold out. How could that be??

As the sponsor of the event, that is both good news and bad. It was great that we had reached our registration goal, but it was not so great that some of my colleagues and friends couldn’t get in!

After a few “behind the scenes” conversations, we were able to expand our room capacity for the event, so the NI Symposium will definitely be another record-breaker for attendance this year. Adding to the evidence, clinician registration for HIMSS12 is 78% ahead of clinician registration for the same number of weeks before HIMSS11.

Does one come of age when reaching 20 years old? Perhaps a specialty does, because in 2012, we are celebrating 20 years of nursing informatics! This is the year that we proudly look back on the past two decades of improving patient care through the best use of technology. And we acknowledge that we are taking on new advocacy and leadership roles for the critical challenges ahead.

The appointments of nurses into important national leadership roles are recent examples. Within the past few months, Judy Murphy RN, FACMI, FHIMSS, FAAN, was appointed as the Deputy National Coordinator for Programs and Policy at the Office of the National Coordinator for Health IT (ONC). Rosemary Kennedy RN, PhD, FAAN, was appointed Vice President for Health Information Technology at the National Quality Forum (NQF). Linda Burnes Bolton DrPH, RN, FAAN, was appointed to the Robert Woods Johnson Foundation Board of Trustees. And Marilyn Tavenner RN, MHA, is now serving as the Acting Administrator for the Centers for Medicare & Medicaid Services, succeeding Donald M. Berwick MD.

Without a doubt, IT is one of the hottest places in healthcare today. Incentives aside, hospitals and health systems are rapidly implementing electronic health record systems and informatics nurses are at the forefront of many of these efforts. Organizations are discovering the numerous advancements they can make by enhancing their ability to use clinical and financial data to improve patient outcomes.

Informatics nurses are essential to the success of these quality initiatives, participating in the executive clinical teams that analyze clinical data. And the recently published IOM report on The Future of Nursing asserts the U.S. healthcare system has the opportunity to transform itself, and envisions nurses as active leaders in this transformation.

The report recommends that nurses take on leadership roles to improve safety and efficiency, bring evidence for decision-making to the point of care, and empower patients as involved partners. If the statistics above are any indication, we are more than well on our way.

Healthcare providers in Camden, Trenton and Newark are expected to launch Medicaid accountable care organizations, or ACOs, early in this year, after the adoption of legislation that paves the way for these urban health care pilot programs to share in the Medicaid cost savings expected to result from innovative health care delivery models.

Last month, I read an article in the Record and Herald News (NJ) (1/24, Washburn) that reported on two more potential ACOs. “Medicare patients in North Jersey will be able to participate in a new style of health care if the federal government approves applications by groups of doctors associated with two Bergen County hospitals. Called ‘accountable care organizations,’ these physician groups have been formed to take advantage of Medicare’s new payment incentives for maintaining or improving patients’ health.”

In the first, “some 240 physicians associated with The Valley Hospital in Ridgewood  formed the Valley Health System Regional Accountable Care Organization,” while in the second, “more than 100 primary-care physicians associated with Hackensack University Medical Center  have formed their own ACO.”

Reading the article reminded of my time as a member of the United Auto Workers (UAW) union, working in a now-closed assembly plant in Bergen County. In 1972, I started work on the Ford assembly plant in Mahwah, NJ . During my 22 years in the UAW, I had the good fortune to marry my bride of 34 years and become a father to my son, who is now 23.  Living and working in the Garden State back then also gave me the opportunity to get my Bachelor of Arts degree from Ramapo College.

Most important to my family was the access I had to the best healthcare possible because of the benefits negotiated through UAW-Ford contracts.  Working in the plant in the day and attending classes at Ramapo College in the evenings and on weekends was a great opportunity for me.  The time at the college also taught me that not all my fellow citizens had the access to healthcare that my family had. 

 Reading about ACOs established in my old neighborhood, and plans for their establishment in other areas of New Jersey, is a positive sign of the future.  As my friend, Assemblyman Herbert Conaway  said, “I am hopeful the federal government will approve these applications by my fellow doctors.  These new initiatives are some of the solutions the President and his advisors are using to curtail the runaway health-care costs as well as improve patient care.”

 Find more information about the status of ACOs in New Jersey.

Any of you who have been to the  Annual HIMSS Conference & Exhibition know what to expect in terms of size (that’s attendance), educational sessions and exhibit booths.  We usually take over the host city, a positive statement for any of our locations, if you interpret the takeover as a reference to booked hotel rooms. This year, we are expecting the same outcome, since registration is 15% ahead of last year, at this same time, two weeks out, before conference.

I thought about what I could share with you on my post here because this is a perfect opportunity to discuss the conference, our speakers, exhibit floor and so many components of the conference.  I am amazed each year as our conference, the country’s largest health IT conference, continues to evolve, to offer more to the diverse audiences that will join us in Las Vegas or attend our Virtual HIMSS12 from their own locations.

But I know you want more from a CEO’s blog post.

I expect a new voice to surface at HIMSS12, as we hear from the vendor community about its role in helping eligible professionals and eligible hospitals reach Stage 1 of meaningful use.

 I’ve seen such comments on various blogs and in healthcare publications I read, where rightly so, vendors explain and extol their own contributions to this important first step in being a meaningful user of technology. These health IT technology companies are integral to successful implementation of health IT systems, and thus, successful attestation for EHR incentive funds for those who are eligible.

As healthcare providers implement a more robust health IT system, the demands on data exchange increase. Think about Stage 7 hospitals that operate in a totally paperless environment and what technology must be in place to ensure that ongoing and seamless operation for consistent patient care. 

The proposed rules for Stage 2 of meaningful use should be released soon, that is, in the next few weeks.  And when that happens, the chatter will transition to more in-depth reviews of what’s ahead and what’s next in this middle stage of the meaningful use timeline to 2014. But that won’t really change my perspective on the hallway, exhibit floor and overall anywhere-conversations on how to reach meaningful use – Stage 1 or Stage 2. 

Improving the quality of healthcare with the best use of IT is a collaborative effort.  You’ll see that in every presentation at HIMSS12, because it takes all of us working together to reach that goal.

So, pay attention to the chatter you hear at the conference…and let me know what you hear…here on the HIMSS Blog.

Tom Judd is among the founding members of the American College of Clinical Engineering (ACCE) and is now its advocacy chair; he joined HIMSS in 2008 and the HIMSS Davies award team in 2010. He holds a national role with Kaiser Permanente (KP), helping his organization and others to find CE-IT solutions for integrating a range of medical device information into EHRs. 

HIMSS: How did you become involved in HIMSS?

Judd: Several ACCE members have contributed significantly to HIMSS in the past decade. ACCE members are the recognized leaders of most CE / health technology management (HTM) programs in the US and around the world; we recognized the power of this collaboration, hosting CE-IT symposia and then member meetings there. I had my first HIMSS experience in 2008, and then, brought 40 international CE / HTM colleagues to HIMSS 2010 in my hometown of Atlanta. I see growing participation by my national and international colleagues with our diverse health IT and CE / HTM needs.

HIMSS: What are the challenges facing Clinical Engineering & IT convergence/collaboration in 2012?

Judd: I agree with challenges noted in the HIMSS12 Symposium on Feb. 20 CE and IT Leadership: Critical Ingredients for Medical Device Connectivity:

-Assess current and future medical device adoption trends, including integration with EHRs, and connectivity;

-Design a road map for clinicians demonstrating how technology plays a growing role in our ability to deliver tomorrow’s patient care;

-Explain the benefits of adopting CE-IT technology management guidelines and a human factors approach to systems of medical devices; and

-Utilize the critical factors that CE-IT and biomedical professionals must embrace to be ready for tomorrow.

Also, I would note the emerging complexity of wireless devices, mHealth clinician and patient systems, risk management and security of health IT, and device alarm management, as this clinical information flows into IT networks and EHRs. There are many resources through the CE-IT Community (ACCE, HIMSS, and AAMI) to address these issues, as well as through a new partner, Medical Device Innovation, Safety and Security Consortium (MDISS).

 HIMSS: Can you describe the events you will be participating in at HIMSS12?

Judd: Of course, various Davies events. And ACCE co-sponsored events;

The CE-IT Symposium on Monday; and the CE-IT Reception / ACCE Awards on Tuesday evening.

  -Monday 2/20 9 am – 5 pm CE & IT Leadership Symposium Critical Ingredients for Medical Device Connectivity

  -The CE-IT Knowledge Center re Device Integration:

The Medical Device Pavilion (held during Exhibit hours) Booth 14647, Hall G

-Tuesday 2/21 5:15 pm   Integration Using Mobile Telecommunication Infrastructure

-Tuesday 2/21 5 pm Meet the Experts: CE & IT –Working Together                                   

-Wednesday 2/22 2:45 pm FDA Guidance. Is it really a medical device?                               

-Thursday 2/23 10 am IHE PCD Road to Interoperability                                                  

ACCE Education Session – at site noted at link                                                                        -Thursday 2/23 9:45 am Clinical Mobile Applications. Is Healthcare ready?

HIMSS: What advice would you give professionals just entering the healthcare CE or IT field?

Judd: Join ACCE, HIMSS, and the CE-IT Community. Learn and network at HIMSS’ annual meetings. In my field, there has not been a defined pathway for young professionals to grow into executive leadership. ACCE is developing a two-day Health IT Executive Summit for this summer – that along with the many health IT stakeholders / executives who will be invited – will further define pathways, tools, and skill-sets to manage increasing complexity and lower risk while helping to enable the promise of health IT.

Dr. Connie Mariano

Dr. Mariano is author of The White House Doctor: My Patients Were Presidents, a memoir about her experiences in the White House and how she got there. A Filipino American doctor, Dr. Mariano has achieved historic firsts throughout her career: she is the first military woman to become White House Physician to the President; the first female Director of the White House Medical Unit; and the first Filipino American in U.S. history to become a Navy Rear Admiral.

Spending nine years as the White House doctor has given Dr. Mariano plenty of stories to choose from for her remarks to Policy Breakfast attendees! She told Jon Stewart on The Daily Show that President George W. Bush was the most fit of the three presidents she served (George H.W. Bush, Bill Clinton, and George W. Bush), and that it was a challenge to get President Clinton to slow down. Dr. Mariano will also share with us her first-hand experiences with electronic health records, both as a Navy physician and now in her private practice.

The Policy Breakfast is invitation-only; if you haven’t received an invitation and would like to attend, please contact Ethan Baron at ebaron@himss.org and we’ll be happy to add your name to a waiting list and notify you if space becomes available. Dr. Mariano will be happy to sign copies of her book for breakfast attendees. The White House Doctor will be on sale at the onsite HIMSS12 Bookstore, or you may purchase it in advance at your local bookstore or online.

So if you get the chance to meet Dr. Connie Mariano at HIMSS12 at the Policy Breakfast or on the Exhibition Hall floor, what questions would you ask her about serving three U.S. Presidents?