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| − | The [[ARRA|American Recovery and Reinvestment Act]] of 2009 authorized the Centers for Medicare & Medicaid Services (CMS) to provide financial incentives to providers and hospitals for adopting [[meaningful use]] of certified [[EMR|electronic health record (EHR)]] technology.
| + | #REDIRECT [[Meaningful use]] |
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| − | Under this authority the [[Office of the National Coordinator for Health Information Technology (ONC)]] has begun to setup standards, implementation specifications, and certification criteria for [[EMR|electronic medical record]] technology. The final rules should be completed by the end of 2010.
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| − | == Guideline ==
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| − | The ONC has listed the following goals as a guide [http://healthit.hhs.gov/portal/server.pt?open=512&objID=1456&parentname=CommunityPage&parentid=31&mode=2&in_hi_userid=11113&cached=true]:
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| − | #Promote interoperability and where necessary be specific about certain content exchange and vocabulary standards to establish a path forward toward semantic interoperability. | + | |
| − | #Support the evolution and timely maintenance of adopted standards
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| − | #Promote technical innovation using adopted standards
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| − | #Encourage participation and adoption by all vendors, including small businesses
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| − | #Keep implementation costs as low as reasonably possible
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| − | #Consider best practices, experiences, policies, frameworks, and the input of the HIT Policy Committee and HIT Standards Committee in current and future standards
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| − | #Enable mechanisms such as the Nationwide Health Information Network (NHIN) to serve as a test-bed for innovation and as an open-source reference implementation of best practices
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| − | #To the extent possible, adopt standard that are modular and not interdependent.
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| − | The standards to be adopted are based on current industry practices and rely on the following: Health Level 7, Inc (HL-7); National Institute of Standards and Technology (NIST) and Integrating the Health care Enterprise (IHE); [[SNOMED|SNOMED CT]]; ICD-9 and 10; X12, [[LOINC]], NCPDP and RxNorm.
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| − | == Controversy ==
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| − | All of this is not without controversy. There are studies emerging that indicate that [[CPOE]] may actually increase medical errors especially if not implemented correctly [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1297629/] [http://www.ncbi.nlm.nih.gov/pubmed/15755942?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed] [http://www.ncbi.nlm.nih.gov/pubmed/15911723?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=3&log$=relatedarticles&logdbfrom=pubmed]. There is evidence that the current CCHIT-certified EHR technology is challenging to use for physicians and hospitals and takes years of training. Dr. Rick Weinhaus, MD wrote an editorial on ''The Health Care Blog'' [http://www.thehealthcareblog.com/the_health_care_blog/]observing that the CCHIT certification model is "fatally flawed because it mandates hundreds of required features and functions, which take precedence over good software design."
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| − | As the US congress moves towards a national policy encouraging the adoption of health care IT, the policies and standards will hopefully be refined because of a ''healthy debate!''
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| − | You may view the entire proposed Electronic Health Record Incentive
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| − | Program by opening the following pdf file[http://edocket.access.gpo.gov/2010/pdf/E9-31217.pdf] or link[http://edocket.access.gpo.gov/2010/E9-31217.htm].
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| − | Submitted by Corey Rammell, MD
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| − | [[Category:BMI512-W-10]]
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