ARRA: American Recovery and Reinvestment Act of 2009, also called “The Stimulus Package” or “The Stimulus Bill.” Of the $850B in the bill, $51B is pegged for the health care industry and $19B of that will be used to incent medical practices to adopt EMRs/EHRs.
CCHIT: the Certification Commission for Health Information Technology is a private organization that certifies EMRs and EHRs based on 475 criteria spanning functionality, interoperability and security. CCHIT does not evaluate ease of use of products, financial viability of the company offering the software; or the quality of customer support offered by the software vendor. Whether or not CCHIT will be THE certifying organization to approve “qualified EMRs” will be announced at the end of the year. (Can be pronounced “SEA-CHIT” or each letter can be pronounced as in “C.C.H.I.T.”)
Comparative Effectiveness: Comparative Effectiveness Research (CER) compares treatments and strategies to improve health. For CER, HITECH provides $300M for the Agency for Healthcare Research and Quality, $400M for the National Institutes of Health, and $400M for the Office of the Secretary of Health and Human Services.
EHR: The aggregate electronic record of health-related information on an individual that is created and gathered cumulatively across more than one health care organization and is managed and consulted by licensed clinicians and staff involved in the individual’s health and care.
EMR: The electronic record of health-related information on an individual that is created, gathered, managed, and consulted by licensed clinicians and staff from a single organization who are involved in the individual’s health and care.
HITECH: The HIT components of the stimulus package ”” collectively labeled HITECH are:
- Funding to the Office of the National Coordinator of HIT (ONCHIT)
- HIT adoption incentives through Medicare and Medicaid reimbursement
- Comparative effectiveness research for the Agency for Healthcare Research and Quality (AHRQ)
- Funding for the Indian Health Service
- Construction funds for the Health Resources and Services Administration (HRSA) for community health centers
- Funds for the Social Security Administration to upgrade HIT systems
- Funding for the Veterans Administration
- The Department of Agriculture will receive telemedicine funding
- Funds to the National Telecommunications Administration for broadband to enable telemedicine.
Interoperability (hospitals): (as defined by HIMSS- Health Information and Management Systems Society) –not yet defined for ambulatory care
- Must have all ancillary systems online – Lab, radiology, & pharmacy (Stage 1)
- Must be leveraging a clinical data repository (Stage 2)
- Utilizing clinical documentation to record patient status during treatment (Stage 3)
- Computerized Physician Order Entry (CPOE) mechanisms in use (Stage 4)
- Be able to exchange Continuity of Care Documents (CCD) with other entities (a portion of Stage 7)
Meaningful Use: To qualify as a “meaningful user,” eligible providers must demonstrate use of a “qualified EHR” in a “meaningful manner.” ARRA defers to the secretary of Health and Human Services (HSS) to set specific guidelines for determining what constitutes a “qualified EHR”; however, it does specify that e-prescribing, electronic exchange of medical records, and interoperability of systems will be determining criteria. Starting in 2011, providers deemed to be “meaningful users” of EHR systems will be eligible to receive $40,000 – $60,000 in incentive payments paid out over five years in the form of increased Medicare and Medicaid payments.
ONCHIT: Office of the National Coordinator for Health Information Technology. In 2004 the position was created by by Presidential Executive Order. In March 2009, President Obama appointed David Blumenthal, M.D., M.P.P. to the position. The primary purpose of this position is to aid the Secretary of HHS in achieving the President’s goal for most Americans to have access to an interoperable electronic medical record by 2014 (from the HHS.gov website.)
PHR or ePHR: An electronic, cumulative record of health-related information on an individual, drawn from multiple sources, that is created, gathered, and managed by the individual. The integrity of the data in the ePHR and control of access to that data is the responsibility of the individual.
David Blumenthal, M.D., M.P.P.:Selected by President Obama as his choice for National Coordinator for Health Information Technology Dr. Blumenthal will lead the implementation of a nationwide interoperable, privacy-protected health information technology infrastructure as called for in the American Recovery and Reinvestment Act.
