tag:blogger.com,1999:blog-4384692836709903146.post5813606147091754210..comments2024-03-27T09:55:23.143-07:00Comments on Dispatch from the Digital Health Frontier: The CMS and ONC NPRMsJohn Halamkahttp://www.blogger.com/profile/04550236129132159307noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-4384692836709903146.post-63898087957242564052015-03-28T17:29:54.328-07:002015-03-28T17:29:54.328-07:00"The certification criteria are often not ali..."The certification criteria are often not aligned with what EHR users ask for...So if certification is loaded by non-EHR users, EHR users are going to find that...their EHRs are focused on a lot of things they haven't asked for."<br /><br />If there IS one thing that users have been asking for, it's better usability. Kudos to ONC for proposing to raise the bar in this area (and Quality Management Systems).<br /><br />Any EHR vendor who's not applying rigorous QMS and UCD at this stage of the game probably doesn't deserve to have their system used in patient care.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-49251668047681287272015-03-27T06:55:21.827-07:002015-03-27T06:55:21.827-07:00Thanks for your thoughtful analysis. One important...Thanks for your thoughtful analysis. One important distinction between Stage 2 and the proposed Stage 3 measure in regard to health information exchange is the change from “or” to “and” in proposed Measure 1. E.g. Stage 2 states “The EP who transitions or refers…” while the proposed Stage 3 for Measure 1 looks at “Number of transitions of care and referrals…”. This change coupled with the increased threshold of sending a SOC electronically makes this measure all the more difficult. Interestingly enough, the proposed Measure 2 and 3 for HIE seem to have left the “or” relationship, giving providers the option of including one or the other. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-46909275028519431742015-03-26T19:24:36.761-07:002015-03-26T19:24:36.761-07:00Thank you, John and Micky. Thus far I had only wai...Thank you, John and Micky. Thus far I had only waited through the CMS proposed rule and was feeling fairly optimistic about stage III. Now I am worried that, if the ONC 2015 Edition gets the final largely intact, many EHR vendors will buckle under the significantly increased certification burden leaving many EPs and EHs stuck with an EHR that doesn't make them eligible for meaningful use. They will have to face the choice of overcoming the tremendous barrier of switching to a certified EHR or taking the penalties on the chin. Market consolidation is inevitable among vendors and providers alike, but will leave the remains of many failed practices in its wake (and, inevitably, disruptions in care). I don't think this is the outcome we are trying to achieve. We all want transformation, but it should be thoughtful and steady, not overreaching and cavalier. (Personal take only)Ross Martinhttps://www.blogger.com/profile/14133264758384138110noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-60041268784484104182015-03-25T12:56:34.791-07:002015-03-25T12:56:34.791-07:00This is an excellent and thoughtful initial review...This is an excellent and thoughtful initial review, including the contrasts between the two rules. I'd urge particular attention to the section on the "Good, Bad, and the Ugly" as well as the initial discussion of development burden and issues associated with the non-Meaningful Use criteria and how these would be approached by the community.Mark Segalnoreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-36858478534577744132015-03-25T12:53:35.362-07:002015-03-25T12:53:35.362-07:00Let's double down on oAuth and RESTful APIs an...Let's double down on oAuth and RESTful APIs and let industry (beyond Epic, that is) help with innovation, patient access, safety, research, etc. etc. etc.Anonymoushttps://www.blogger.com/profile/05914410956085626950noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-38206848734795055662015-03-25T08:50:30.835-07:002015-03-25T08:50:30.835-07:00Thanks for trying to distill this down John. You h...Thanks for trying to distill this down John. You have done a masterful job at taking the rather convoluted regs and put them in context.<br /><br />This is complicated, but just imagine how crazy it will all get when the SGR bill passes and meaningful use, PQRS and value based payments are all consolidated into one program - Merit-based Incentive Payment System. I think it is very likely that this is going to happen in the next three weeks and this would obviously have some pretty huge health IT implications...Ahierhttps://www.blogger.com/profile/13398190978662246852noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-80810929007969725572015-03-25T07:09:11.193-07:002015-03-25T07:09:11.193-07:00Thanks so much for this breakdown. Always enjoy a...Thanks so much for this breakdown. Always enjoy and appreciate Dr. Halamka's perspective on these complicated subjects. <br /><br />One area that remains unclear to me is around "notifications of significant healthcare events to members of a patients care team". This was noted as a new objective/measure in the draft recommendations. However, I've read through the documents and it looks like this may have been removed. Personally, I thought that was a very interesting and important measure for truly enhancing care coordination.<br /><br />Curious if anyone has interpreted the most recent recommendations differently and still believe that Notifications are included as an objective/measure? <br /><br />Thanks!Jasonnoreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-81740546861944545572015-03-25T05:16:40.074-07:002015-03-25T05:16:40.074-07:00I'm forever thankful I'm not a physician w...I'm forever thankful I'm not a physician who just wants to practice medicine. <br />The level of micromanagement and barrier setting to actual patient contact and analysis embodied by these criteria are both financially unsustainable and detrimental to providing care.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-17106595197099938602015-03-24T21:48:22.796-07:002015-03-24T21:48:22.796-07:00Thanks for the excellent #MU3 summary! Join #MU3 t...Thanks for the excellent #MU3 summary! Join #MU3 tweetchat on 3/26 @ 3pmET! Load up on caffeine & strap in!@pjmachadonoreply@blogger.com