Archive for May, 2011

IOM Publishes Workshop Series Summary: Digital Infrastructure for the Learning Health System

Earlier this morning, the Institute of Medicine (IOM) held a public meeting to announce the publication of its workshop series summary, “Digital Infrastructure for the Learning Health System: The Foundation for Continuous Improvement in Health and Health Care.”  The summary addresses how EHRs, PHRs, Meaningful Use (MU), and other technologies and federal initiatives can facilitate progress toward a “Learning Health System (LHS).”

The workshop series was part of the IOM Roundtable on Value and Science-Driven Health Care‘s LHS initiative, which is intended to develop 11 publications discussing how science, informatics, incentives, and culture can be aligned for continuous improvement in medicine.   The Roundtable has been active since 2006 exploring various aspects of the LHS concept.

Chuck Friedman (Chief Scientific Officer, Office of the National Coordinator for HIT) discussed ONC’s thoughts and plans related to the LHS concept at today’s meeting.  The overarching theme of Dr. Friedman’s talk was that MU plus a “delta” equals the LHS; and it is the goal of ONC and others to identify or define the delta.  He mentioned that there are several ongoing projects within four federal agencies that comprise the Federal LHS Working Group to see if a single LHS can be formed using shared technologies and policies.  Dr. Friedman also mentioned that ONC will sponsor a new IOM study on what levels of data quality are needed for different types of learning.

Categories: EHR, IOM, meaningful use, research

ACR Testimony from the May 13 Meaningful Use Workgroup Hearing

May 18, 2011 1 comment

The Office of the National Coordinator for HIT (ONC) released the audio from the May 13 HIT Policy Committee-Meaningful Use (MU) Workgroup hearing on “specialists and MU.”  The written transcript should be available within the next few weeks.

Dr. Keith Dreyer (Co-Chair, American College of Radiology’s IT and Informatics Committee) was a witness on Panel 2 addressing EHR functionality and clinical decision support.   His formal testimony begins at the 1:43:18 mark of the audio, and the question-and-answer component starts at 1:59:26.

Most of the questions from the MU Workgroup members to the five panelists were about image sharing and ACR Appropriateness Criteria, including two from the chair, Dr. Paul Tang.  In person, the members were clearly engaged and informed by Dr. Dreyer’s responses.  This is only somewhat apparent when listening to the audio.

It remains to be seen whether or not the MU Workgroup will make any changes to their draft recommendations for Stage 2 MU functionality objectives/measures based on the lessons learned from the May 13 hearing.  The MU Workgroup’s final recommendations will be presented to the full HIT Policy Committee for approval on June 8.

Categories: EHR, meaningful use, Medicare

ACR Announces the Launch of the Dose Index Registry


ACR National Radiology Data Registry

The American College of Radiology recently announced the launch of its Dose Index Registry (DIR) for submitting radiation dose index information for CT exams.  The DIR will allow participants to compare dose indices with those of other facilities, which will promote enhanced safety and quality.

Establishment of a national radiation dose registry is a policy priority of the Food and Drug Administration’s Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging.  In its white paper for the initiative, FDA stated:

“By pooling dose data across imaging facilities nationwide, a national radiation dose registry will help support the development of diagnostic reference levels where they do not yet exist, and allow for broad validation of those levels that have been developed to date.  Such a registry will also help facilities benchmark their radiation doses relative to those of others, and could be a key source of information about trends in doses over time.”

Visit the ACR’s National Radiology Data Registry to learn more about the DIR.

Categories: FDA, research

Update Regarding May 13 Meaningful Use Workgroup Hearing

The Office of the National Coordinator for HIT (ONC) recently made available the written submissions from the panelists for the May 13 HIT Policy Committee-Meaningful Use (MU) Workgroup hearing on “MU and Specialists.”

Dr. Keith Dreyer of ACR’s IT and Informatics Committee  is a panelist for the second topic on the agenda, “EHR Support for Specialists in Patient Care Plus CDS.”  His presentation will focus on appropriateness clinical decision support, imaging information exchange, and the need for specialty-relevant MU requirements.

The hearing will begin tomorrow (May 13) at 8:30am (Eastern).  To view the webcast, please visit at that time.  The hearing will also be accessible via phone at 1-877-705-2976 (domestic) / 1-201-689-8798 (international).  ONC plans to archive an audio file of the hearing within a couple of days and a written transcript within a few weeks.

Categories: EHR, meaningful use, Medicare

Full HIT Policy Committee Discusses Progress of MU Workgroup’s Draft Recommendations for Stage 2

The full HIT Policy Committee (HITPC) held its May public meeting earlier today.  The HITPC Meaningful Use (MU) Workgroup provided the committee members with an update regarding their effort to finalize recommendations for potential future Stage 2 MU functionality objectives/measures.

The MU Workgroup continues to support a “functionality enabled”-type measure for radiology order entry rather than a percentage-based measure, as this blog described on April 5.  However, some of the HIT Policy Committee members expressed concern that the radiology order entry recommendation was not aggressive enough to support some of the advanced performance metrics intended for the Stage 2  “report clinical quality measures” MU objective.  The need for more detail in the radiology order entry recommendation will also be reflected in Dr. Keith Dreyer’s (ACR IT and Informatics Committee) testimony for the upcoming May 13 MU Workgroup hearing for specialists.

Moving forward, the MU Workgroup’s specialist hearing will be held this Friday the 13th.  Later, the Workgroup will modify its advice and present final recommendations for approval of the full HIT Policy Committee on June 8.  Note that the various recommendations of the HIT Policy Committee and its workgroups are merely advisory, and the regulatory agencies (CMS and ONC) are free to use, or not use, the advice however they see fit during the upcoming Stage 2 rulemakings.

Categories: EHR, meaningful use, Medicare

Recap of Recent Federal HIT Policy Developments: Part 2

There were several miscellaneous federal HIT policy developments over the past week.

The Centers for Medicare and Medicaid Services (CMS) held a series of conference calls on the EHR Incentive Program’s online attestation process.   The presentations from the calls are available on the CMS website.  CMS will hold its next call on May 19 regarding the topic of “Understanding Meaningful Use.”

The Health Resources and Services Administration (HRSA) released a Rural Health Information Technology Network Development (RHITND) Program grant opportunity to support rural providers who work in formal networks, alliances, coalitions, or partnerships to comply with requirements of the Medicare/Medicaid EHR Incentive Program.  The RHITND funds will essentially provide strategic and business planning, workforce analyses, technology identification and purchases, broadband access, and more, for approximately 40 rural HIT networks.

Yesterday, the Office of the National Coordinator for HIT (ONC) distributed an email to stakeholders describing the HRSA RHITND grant opportunity.  The information from the ONC’s notification can be accessed here.

The Centers for Disease Control and Prevention (CDC) published a request for public comment in the May 5 Federal Register on the draft PHIN Messaging Guide for Syndromic Surveillance.  The draft translates business recommendations from the International Society for Disease Surveillance to technical specifications to support the syndromic surveillance meaningful use objective and corresponding EHR certification criteria/standards/implementation specifications.

ONC Releases Draft Agenda for May 13 Meaningful Use Workgroup Hearing on Specialists

May 3, 2011 1 comment

The Office of the National Coordinator for HIT (ONC) recently released the draft agenda for the May 13, 2011 public meeting of the HIT Policy Committee-Meaningful Use (MU) Workgroup regarding “MU and specialists.”

As I wrote on April 25, the ACR IT and Informatics Committee-Government Relations Subcommittee Chair, Dr. Keith Dreyer (MGH), was invited to participate on the second panel regarding “EHR Support of Specialists in Patient Care and CDS.”  ACR released a news article on April 28 discussing the invitation and upcoming event.

Other invited specialty societies include the College of American Pathologists, American College of Surgeons, American Academy of Allergy, Asthma & Immunology, and American Academy of Ophthalmology.

At this writing, up to 10 of the 18 panelists listed on the draft agenda are either from a primary care specialty, or otherwise not representing the interests of a physician specialty.  This could be a point of contention for many other specialty societies who are still trying to communicate their concerns to the ONC and its advisory committees.

Categories: EHR, meaningful use, Medicare
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