Las Vegas, February 23, 2012 – Dispatches and thoughts overheard from senior editors at Health Data Management magazine from the 2012 Health Information and Management Systems Society (HIMSS), which attracted more than 30,000 attendees to Las Vegas this week.

The most important headline of the conference, previewed Wednesday, was the new rules for Meaningful Use Stage 2 incentives for electronic health records (EHRs), formally released today. Observers call the requirements a compromise between tighter requirements and flexibility for providers.  

    Health Data Management news editor Joe Goedert: “Meaningful use of electronic health records was the main event in terms of news this year. You’re talking about a $27 billion incentive program paying providers to not only create EHRs but to use certain functions of those records and charts and share the data.”    
    The revisions, which keep some elements and change others from the Stage 1 mandate, include 18 measures for hospitals and a different list for individual providers. Among Stage 2 provisions for eligibility: at least 50 percent of hospital and practice patients must be able to access and transfer electronic copies of their own histories online within four days notice.

    Dr. Farzad Mostashari from the Office of the National Coordinator (ONC) for Health Information Technology told an overflow gathering Wednesday that to make “true meaningful use of Meaningful Use” was the spirit of the update for providers that had been asked to move too quickly.

    A related buzz was around the incumbent arrival of Health Information Exchanges, which unite data among practices, not just in a hospital system but among different providers. Says Goedert: “The health IT provisions were put in that [stimulus] bill specifically as a stepping stone for reform that came a year later.” The notices of proposed rule making (NPRMs) in the Stage 2 release include provisions for greater interoperability and flexible application design.

      A third topic at the conference is the Accountable Care Organization provisions of health care law tying reimbursements to quality metrics, which roll up into the Federal mandate mix. “You need EHRs, you need Health Information Exchange, you need data analytics,” Goedart says, adding that ACO hurdles are many, because hospitals and their affiliated physicians and clinicians don’t talk or play well, or share information.

        In a wider view of the conference, Health Data Management Editor-in-Chief Greg Gillespie says his industry continues an uphill data management slog in many areas, compared to other industries.

          “A lot of health care deployment remains behind other industries, and certainly there are aspects of hospice and long term-care and other areas of patient care and even anesthesiology that are completely un-automated.”
          Investments in old incentives and motivations have given way in the rise of data-based technologies and the introduction of federal mandates for standards of performance and patient well-being.

          “A lot of the data [providers previously worked with] was comparing finance and clinical services and the question was, ‘Where are we losing money?’ and that was driven by the business goal,” Gillespie says. “The goal was to maximize reimbursements and the thinking was, ‘If I screw up and someone is injured, they are going to come back and we’ll get paid again.’”

          With the arrival of research based quality standards, health care providers now must compare their services to those of others and answer mandates for improvement. They are under pressure to create data exchanges with other providers, adhere to new standards for interoperability and integrate them to their own infrastructure.

          “Now it’s all coming together,” Gillespie says. “You have to cut costs and improve services and that’s where you are seeing all the analytics. I don’t think it’s because they didn’t know about analytics or didn’t want to, but now the regulations have changed the incentives.”

          More announcements from the conference are available at the HIMSS event website.

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