ONC announces launch of "Direct Project" pilots

The Office of the National Coordinator for Health IT (ONC) announced today that providers and public health agencies in Minnesota and Rhode Island began this month exchanging health information using specifications developed by the Direct Project, an 'open government' initiative that calls on cooperative efforts by organizations in the health care and information technology sectors.  Other Direct Project pilot programs will also be launched soon in New York, Connecticut, Tennessee, Texas, Oklahoma and California to demonstrate the effectiveness of the streamlined Direct Project approach, which supports information exchange for core elements of patient care and public health reporting. 

The launch of the pilot demonstrations, less than a year from the inception of the Direct Project, shows the project is on track to give U.S. health care providers early access to an easy-to-use, internet-based tool that can replace mail and fax transmissions of patient data with secure and efficient electronic health information exchange.

"This is an important milestone in our journey to achieve secure health information exchange, and it means that health care providers large and small will have an early option for electronic exchange of information supporting their most basic and frequently-needed uses," said Dr. David Blumenthal, national coordinator for health information technology.  "Other efforts are also going forward at full-throttle to build a comprehensive structure of health information exchange.  But by bringing together health care and IT companies, including competitors, to rapidly produce a system that supports basic clinical delivery and public health needs, we will be able to more quickly start building electronic information exchange into our health care system."

Designed as part of President Obama's 'open government' initiative to drive rapid innovation, the Direct Project last year brought together some 200 participants from more than 60 companies and other organizations.  The volunteers worked together to assemble consensus standards that support secure exchange of basic clinical information and public health data.  Now, pilot testing of information exchange based on Direct Project specifications is being carried out on schedule this year, aiming toward formal adoption of the standards and wide availability for providers by 2012.

"This is a new approach to public sector leadership, and it works," said Aneesh Chopra, the United States Chief Technology Officer.  "Instead of depending on a traditional top-down approach, stakeholders worked together to develop an open, standardized platform that dramatically lowers costs and barriers to secure health information exchange. The Direct Project is a great example of how government can work as a convener to catalyze new ideas and business models through collaboration."

The two pilot programs that have already begun using Direct Project-based information exchange are in Minnesota and Rhode Island:

Since mid-January, Hennepin County Medical Center (HCMC), Minnesota's premier Level 1 Adult and Pediatric Trauma Center, has been successfully sending immunization records to the Minnesota Department of Health (MDH). "This demonstrates the success that is possible through public-private collaborations," said James Golden, PhD, Minnesota's state HIT coordinator. "This is an important milestone for Minnesota and a key step toward the seamless electronic movement of information to improve care and public health." 

Recognizing Minnesota's leadership in delivering high-quality, cost-effective healthcare, U.S. Senator Amy Klobuchar (D-MN) said, "this is the type of innovation that can help strengthen our health care system by reducing waste and improving quality. We need to continue to improve our health care system by continuing to integrate information technology to better serve patients and providers."
The second pilot implementation site, The Rhode Island Quality Institute (RIQI), has delivered a pilot project with two primary goals. First, RIQI is improving patient care when patients are referred to specialists by demonstrating simple, direct provider-to-provider data. Second, RIQI is leveraging Direct Project messaging as a means to securely feed clinical information, with patient consent from practice-based EHRs to the state-wide HIE, currentcare, to improve quality by detecting gaps in care and making sure the full record is available to all care providers.

Discussing RIQI's collaborative approach to health IT, Laura Adams, president and CEO of RIQI said, "All too often, providers do not have the data they need to take the best care of patients they serve. Direct Project allows the Quality Institute to be on the cutting edge - providing health information exchange via currentcare, delivering the efficient rollout of technology through the Regional Extension Center, and enabling and measuring real patient outcome improvements in our Beacon Community. The ability to bring together and drive consensus among a diverse set of stakeholders has been critical in the successful rollout of these innovative programs."

"Rhode Island continues to be a nationwide leader in improving health care with better information technology," said Senator Sheldon Whitehouse (D-RI). "Health care providers communicating with each other in a secure and cost-efficient way helps patients get better sooner with less hassle and confusion."

Other pilot projects to be launched this year include a Tennessee effort with the Veteran's Administration, local hospitals and CareSpark to provide care to veterans and their families; a New York effort including clinicians in hospital and ambulatory care settings with MedAllies and EHR vendors; a Connecticut effort involving patients, hospitals, ambulatory care settings and a Federally Qualified Health Center with Medical Professional Services, a PHR, and a major reference laboratory; an expansion of the VisionShare immunization data pilot to Oklahoma; a California rural care effort involving patients, hospitals and ambulatory care settings with Redwood MedNet; and an effort in South Texas with a collaboration of hospitals, ambulatory care settings, public health, and community health organizations to improve care to mothers with gestational diabetes and their newborns.

The Direct Project was launched in March 2010 as a part of the Nationwide Health Information Network, to specify a simple, secure, scalable, standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet in support of Stage 1 Meaningful Use requirements.  Participants include EHR and PHR vendors, medical organizations, systems integrators, integrated delivery networks, federal organizations, state and regional health information organizations, organizations that provide health information exchange capabilities, and health information technology consultants.

Information transfers supported by Direct Project specifications address core needs, including standardized exchange of laboratory results; physician-to-physician transfers of summary patient records; transmission of data from physicians to hospitals for patient admission; transmission of hospital discharge data back to physicians; and transmission of information to public health agencies.  In addition to representing most-needed information transfers for clinicians and hospitals, these information exchange capabilities will also support providers in meeting "meaningful use" objectives established last year by HHS, and will thus support providers in qualifying for Medicare and Medicaid incentive payments in their use of electronic health records.  The Direct Project specifications can also support physician-to-patient information transfers, and Microsoft Corp. today announced an application for that purpose based on Direct Project standards. For more information about the Direct Project, please visit http://directproject.org.

Other ongoing efforts supported by ONC are underway to bring about a comprehensive health information structure in the U.S.  These include technical and governance issues that are being addressed under the Nationwide Health Information Network, which embodies the standards, services and policies that enable health information exchange over the internet.  The Nationwide Health Information Network Exchange is already supporting some health information exchange between federal agencies and the private sector.  In addition, ONC provides grants to states to develop locally-appropriate policies and standards for health information exchange that are consonant with broader national standards.

For more information about the Office of the National Coordinator for Health Information Technology, please visit http://healthit.hhs.gov.


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Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.

Physician EMR Use Passes 50% as Incentives Outweigh Resistance

By Bob Cook, amednews staff

25% of office-based physicians have a basic EMR system and 10% have a fully functional system.

The transition has happened for a number of reasons, technology analysts say. One is simple demographics: As more older physicians retire and more freshly minted doctors join the work force, the resistance to EMRs lessens. (A previous 2010 CDC report said the younger the doctor, the more likely he or she was to embrace EMRs.) But the resistance has lessened even among older physicians, who have grown more comfortable with EMRs as they have become more common in offices and hospitals. "The fear factor is dissipating," said Mary Shacklett, CEO of Transworld Data, a technology research and consulting firm in Olympia, Wash.

Another major factor: financial assistance and incentives to get physicians to adopt.

In 2006, the Dept. of Health and Human Services granted Stark law exceptions and anti-kickback safe harbors to hospitals through Dec. 31, 2013, so they could help affiliated practices finance EMRs and other technology. A July 2010 study from consulting firm CSC said one-third of hospitals have offered financial assistance to physicians for EMRs, and more than 60% of hospitals offer physicians access to the hospital's EMR and a hosted EMR for physicians delivering ambulatory care.

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Electronic Medical Record vs. Electronic Health Record: Clarifying the EHR/EMR Difference « Health IT Buzz

Posted by: Peter Garrett ONC Office of Communications and Joshua J. Seidman PhD Director Meaningful Use

What’s in a word? Or, even one letter of an acronym?

Some people use the terms “electronic medical record” and “electronic health record” (or “EMR” and “EHR”) interchangeably. But here at the Office of the National Coordinator for Health Information Technology (ONC), you’ll notice we use electronic health record or EHR almost exclusively. While it may seem a little picky at first, the difference between the two terms is actually quite significant.The EMR term came along first, and indeed, early EMRs were “medical.” They were for use by clinicians mostly for diagnosis and treatment.

In contrast, “health” relates to “The condition of being sound in body, mind, or spirit; especially…freedom from physical disease or pain…the general condition of the body.” The word “health” covers a lot more territory than the word “medical.” And EHRs go a lot further than EMRs.

What’s the Difference?   Continue Reading

Lessons from a Health Information Technology Demonstration in New York Nursing Homes

by Shana Lieberman Klinger and Scott White

The New York State Nursing Home Health Information Technology (HIT) Demonstration Project is a publicly subsidized initiative to implement comprehensive, point-of-care electronic medical records in 20 New York City nursing homes. Because of an innovative union–employer partnership, direct-care staff of the homes were heavily involved in the planning process. Union employees were assured upfront that no layoffs would result from HIT implementation, and training was a high priority in vendor selection.

All participating homes successfully replaced paper records with electronic ones, and, after the intensive pre-implementation planning period, it took less than six months on average for facilities to make this transition. Despite this shared success, variation existed between homes regarding: 1) organizational aims for adapting HIT; 2) the technology’s perceived or real effects; and 3) implementation of quality improvement efforts as a result of newly available data.
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National Progress Report on eHealth - The Commonwealth Fund

A new report from eHealth Initiative—an organization that seeks to help health care industry stakeholders better understand and use health information technology (IT)—tracks developments over the past three years in promoting the adoption and use of health IT. Supported by The Commonwealth Fund, the National Progress Report on eHealth finds that:

• Significant advances have been made as a result of public and private sector initiatives. The 2009 American Recovery and Reinvestment Act, which allocated $30 billion to promote health IT, has been a key driver of progress.
• Many providers are concerned about the lack of coordination across government health and health information technology initiatives.
• More education and outreach to consumers about health IT and health information exchange are needed.
• Knowledge and transparency of privacy and security policies will be key to building consumer trust.

More than a hundred experts helped assess progress in the following five areas: aligning incentives, engaging consumers, improving population health, managing privacy, security and confidentiality, and transforming care delivery. Stakeholders’ perceptions of progress were also gauged. Sixty-one percent agreed or strongly agreed that significant progress has been made in the successful adoption and use of health IT since 2007, but most (67%) felt that outreach to educate consumers about the value of electronic health records and health information exchanges is not effective.

To realize the goal of using health IT adoption to improve quality in care delivery, the report recommends implementing policies and programs that take into consideration all sectors of the health care community, including consumers, and promoting further education on the new privacy and security laws and regulations.

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Consumer Choice Technology Hearing

Tuesday, June 29, 2010  |  8 a.m. to 5:15 p.m.

Grand Hyatt Hotel
1000 H Street, N.W., Washington, DC 20001
Meeting Location: Constitution Ballroom, Constitution Level

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Held by the Privacy and Security Tiger Team, the meeting will be a discussion about technologies that enable consumers to choose whether or not to share their information in a health information exchange. The morning session will be devoted to hearing testimony from current users of these technologies, followed by developer demonstrations.

The afternoon session will feature testimony and demonstrations by developers of "cutting edge" technologies that may, in the future, be useful in the clinical care setting. After both sessions, a panel of experts will ask questions of the presenters. The Tiger Team will also have time to ask questions of the presenters and the experts. The hearing is open to the public, and there will be time in both the morning and afternoon for public testimony and questions. A preliminary agenda (subject to change) and Web registration form are available on the hearing Web site.

Register Now  |  View Agenda   (50.3 KB)  |  Get Hotel Information 

IT Saves $3 Billion in VA Health System from MedPage Today

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By John Gever, Senior Editor, MedPage Today

The Department of Veterans Affairs' long-term investment in healthcare information technology paid off at a rate of more than $500 million in net annual benefits from 2001 to 2007, researchers said.

That added up to more than $3 billion in benefits for the Department of Veterans Affairs (VA) during the study period, after an initial billion-dollar loss.

In particular, the department's computerized patient record system "was the dominant contributor to both benefits and costs in our analysis," wrote Colene M. Byrne, PhD, and colleagues at the Center for Information Technology Leadership in Charlestown, Mass., in the April issue of Health Affairs.
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Electronic Personal Health Information Exchange

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Why GAO Did This Study

Health Care Entities' Reported Disclosure Practices and Effects on Quality of Care Highlights of GAO-10-361, a report to congressional committees

To promote the use of information technology for the electronic exchange of personal health information among providers and other health care entities, Congress passed the Health Information Technology for Economic and Clinical Health (HITECH) Act. It provides incentives intended to promote the widespread adoption of technology that supports the electronic sharing of data among hospitals, physicians, and other health care entities. Pursuant to a requirement in the HITECH Act, GAO is reporting on practices implemented by health information exchange organizations, providers, and other health care entities that disclose electronic personal health information.

GAO’s specific objectives were to describe (1) the practices implemented for disclosing personal health information for purposes of treatment, including the use of electronic means for obtaining consent, as reported by selected health information exchange organizations, their participating providers, and other entities; and (2) the effects of the electronic sharing of health information on the quality of care for patients as reported by these organizations.

To address both objectives, GAO conducted case studies of 4 of more than 60 operational health information exchanges and a selection of each of the exchanges’ participating providers.

What GAO Found

The health care entities GAO studied reported that they implement disclosure practices that reflect widely accepted practices for safeguarding personal information–the Fair Information Practices–to help ensure the appropriate use and disclosure of electronic personal health information for treatment purposes. For example, providers in the study described various implementations of practices that require direct interaction with patients, such as informing patients of the use and disclosure of personal health information and providing patients access to their own records. Some of them inform patients that their electronic personal health information may be shared through health information exchanges–entities that were formed to facilitate the electronic sharing of patients’ health information among providers. Both the providers and exchanges in the study described practices that limit disclosure of information, secure electronic information that they store and transmit, and help ensure accountability for safeguarding electronic personal health information.

Although the health information exchanges reported that they have not conducted formal studies or evaluations of the overall effect of electronically sharing personal health information, both the exchanges and providers reported examples of ways that sharing electronic personal health information about patients has had a positive effect on the quality of care that providers deliver to patients.

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A Doctor’s Problem With Electronic Records - Health Blog - WSJ

By James A. White

Paper medical records can easily go missing, contain bad or missing information and undermine patient care. But consider the alternative, says Alexander Friedman, a fellow in maternal-fetal medicine at the University of Pennsylvania.

Friedman says EMRs are designed to communicate with insurers, not for care providers to communicate with each other. At the same time, he notes the success of the Veterans Administration’s electronic system in producing dramatic care improvements, as cited in a 2003 NEJM study.

But he sees the VA’s broad effort to apply electronics for improving accountability, integrating services and improving patient safety as an exception to how most systems are designed.
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HHS Seeks Comments on “Meaningful Use” Regulation Involving Accessibility of Electronic Health Records

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Electronic health records (EHR) are at the cutting edge of health information technology and a tool which has the potential to improve the quality and delivery of health care for all Americans. The HHS Office on Disability writes to advise you of an opportunity for disability community stakeholders to weigh in, as EHR policies and standards are being developed and implemented.

In late December, the Centers for Medicaid and Medicare Services (CMS) released a notice of proposed rulemaking that defined how health care providers can demonstrate “meaningful use” of electronic health records that would qualify themselves for Federal incentive payments made available under the American Recovery and Reinvestment Act of 2009 (ARRA) (Pub. L. 111–5.). At the same time, the Office of the National Coordinator (ONC) for Health Information Technology released an interim final rule describing certification standards for Electronic Health Records (EHR) technology.

On January 13, 2010, both the CMS notice of proposed rulemaking and the ONC interim final rule were published in the Federal Register, launching a 60-day public comment period. ONC states that with regard to EHR, the “accessibility requirements of the Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 still apply to entities covered by these Federal civil rights laws.”

Furthermore the interim final rule specifically requests feedback on the following item which may be of interest to you and your constituents:

We are interested in public comments to inform future deliberations on whether specific certification criteria could be adopted to further promote the capabilities Certified EHR Technology should provide with respect to meeting the accessibility needs of individuals with disabilities. Federal Register, Vol. 75, No. 8, Wednesday, January 13, 2010, Proposed Rules (p. 2005)

You have the opportunity to share your insights and suggestions about the accessibility of electronic health records and the above question with the Office of the National Coordinator. To be assured consideration written or electronic comments for both the ONC interim final rule and the CMS Notice of Proposed Rulemaking must be received at one of the below addresses no later than 5 p.m. on March 15, 2010.

1. Instructions For Submitting Comments On The Interim Final Rule (from the Federal Register) - Office of the National Coordinator

Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. You may submit comments, identified by RIN 0991– AB58, by any of the following methods (please do not submit duplicate comments).

• Federal eRulemaking Portal: Follow the instructions for submitting comments. Attachments should be in Microsoft Word, WordPerfect, or Excel; however, we prefer Microsoft Word. http://www.regulations.gov.

• Regular, Express, or Overnight Mail: Department of Health and Human Services,
Office of the National Coordinator for Health Information Technology, Attention: HITECH Initial Set Interim Final Rule, Hubert H. Humphrey Building, Suite 729D, 200 Independence Ave., SW., Washington, DC 20201. Please submit one original and two copies.

• Hand Delivery or Courier: Office of the National Coordinator for Health Information Technology, Attention: HITECH Initial Set Interim Final Rule, Hubert H. Humphrey Building, Suite 729D, 200 Independence Ave., SW., Washington, DC 20201. Please submit one original and two copies.

(Because access to the interior of the Hubert H. Humphrey Building is not readily available to persons without federal government identification, commenters are encouraged to leave their comments in the mail drop slots located in the main lobby of the building.)

FOR FURTHER INFORMATION CONTACT: Steven Posnack, Policy Analyst, 202– 690–7151.

2. Instructions For Submitting Comments On The CMS Notice Of Proposed Rulemaking - Centers for Medicare and Medicaid Services

ADDRESSES: In commenting, please refer to file code CMS–0033–P. Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. You may submit comments in one of four ways (please choose only one of the ways listed):

1. Electronically. You may submit electronic comments on this regulation to http://www.regulations.gov. Follow the instructions on the home page.
2. By regular mail. You may mail written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS–0033–P, P.O. Box 8013, Baltimore, MD 21244–8013. Please allow sufficient time for mailed comments to be received before the close of the comment period.

3. By express or overnight mail. You may send written comments to the following address only: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS–0033–P, Mail Stop C4–26–05, 7500 Security Boulevard, Baltimore, MD 21244–1850.

4. By hand or courier. If you prefer, you may deliver (by hand or courier) your written comments before the close of the comment period to either of the following addresses:

a) For delivery in Washington, DC—Centers for Medicare & Medicaid Services, Department of Health and Human Services, Room 445–G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201.

(Because access to the interior of the Hubert H. Humphrey Building is not readily available to persons without Federal government identification, commenters are encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp-in clock is available for persons wishing to retain a proof of filing by stamping in and retaining an extra copy of the comments being filed.)

b. For delivery in Baltimore, MD— Centers for Medicare & Medicaid Services, Department of Health and Human Services, 7500 Security Boulevard, Baltimore, MD 21244–1850. If you intend to deliver your comments to the Baltimore address, please call telephone number (410) 786– 9994 in advance to schedule your arrival with one of our staff members.

Comments mailed to the addresses indicated as appropriate for hand or courier delivery may be delayed and received after the comment period.

FOR FURTHER INFORMATION CONTACT:
Elizabeth Holland, (410) 786–1309, EHR incentive program issues.
Edward Gendron, (410) 786–1064, Medicaid incentive payment issues.
Jim Hart, (410) 786–9520, Medicare fee for service payment issues.
Terry Kay, (410) 786– 4493, Medicare fee for service payment issues.

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Delaware: First Statewide Health Information Exchange

Delaware established the first statewide clinical health information exchange (HIE) in 1997. Compared with other states, it has taken more of a public sector approach to HIE governance, though this strategy may be shifting. Its HIE, the Delaware Health Information Network (DHIN), is a public–private partnership that operates under the auspices of the Delaware Health Care Commission, which the state created in 1990 with the goal of moving toward basic, affordable health care for all residents.
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Arizona Medical Information Exchange Outgrows Medicaid - The Commonwealth Fund

This article first appeared in the October/November 2009 issue of the newsletter "States in Action."

The Arizona Medical Information Exchange (AMIE) is a Web-based health information exchange that allows participating practitioners to view hospital discharge and other clinical reports, lab test results, and medication data for many of their patients. AMIE was developed by Arizona's Medicaid agency (the Arizona Health Care Cost Containment System, or AHCCS), went live in September 2008, and is slowly growing in capabilities and utilization. Focused primarily on the Phoenix region, AMIE is the only operational HIE in the state, and will play a key role as it works to build interoperability with other developing exchanges in the region.

Arizona recently submitted a proposal for federal stimulus funds (under the State Health Information Exchange Cooperative Agreement Program) to support a cooperative effort among AMIE, another HIE developing in the southern region in the state, and several smaller HIE efforts under way. The goal is to make these HIEs interoperable, essentially building a statewide system in which the whole will be greater than the sum of its parts. A new state HIT coordinator will oversee this collaborative effort.
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The Health Care Blog: Health 2.0: Beneath the Hype, There's Cause for Real Hope

By MICHAEL MILLENSON

Health 2.0 is a trend accompanied by both buzz and buzzwords. That worries some advocates for the poor, underserved and just plain old and sick. Will those groups be left behind in the latest information revolution?
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MEDICARE PART D E-PRESCRIBING STANDARDS: EARLY ASSESSMENT SHOWS PARTIAL CONNECTIVITY

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The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 established the Medicare Part D e-prescribing program, which stipulates that plan sponsors must implement e-prescribing standards specified by the Secretary of the Department of Health and Human Services (the Secretary).

Between August and September 2008, GAO surveyed all Part D plan sponsors for plan year 2008 to determine the extent of their implementation of the standards. GAO received responses from 262 plan sponsors for a 94-percent response rate.

FINDINGS
Nearly 80 percent of plan sponsors reported at least partial plan-to-prescriber connectivity but few reported complete connectivity. Seventy-seven percent of plan sponsors responding to our survey reported either partial or complete implementation of the plan-to-prescriber standards. Sixty-nine percent of plan sponsors reported partial plan-to-prescriber connectivity. In contrast, only 8 percent of plan sponsors reported complete connectivity. Additionally, 16 percent of plan sponsors reported no plans to achieve plan-to-prescriber connectivity. The remaining plan sponsors did not provide information on plan-to-prescriber connectivity.
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AMNews: Aug. 17, 2009. Health information networks gain wider use ... American Medical News

As more data are exchanged, a survey finds that stakeholders are realizing a return on their investments. Read More

AMNews: Aug. 17, 2009. Practices see slow progress in instant claims adjudication ... American Medical News

By Victoria Stagg Elliott, AMNews staff. Real-time adjudication, which allows a claim to be submitted to an insurer and settled before a patient leaves the office, seems like something physicians, patients and insurers can support. Physicians who use it can shorten the revenue cycle and reduce bad debt. Patients like it because they don't get a surprise bill weeks after receiving care. Even insurers like it, because administrative costs of billing and handling inquiries about claims are reduced. Read More

Fragmented thinking (gov and industry) hobbles healthcare technology enablement | Aging In Place Technology Watch

by Laurie Orlov

Devices, devices, everywhere. I guess I just don't get telehealth-related technology 'progress' -- it seems like two steps forward in one area and a few backward somewhere else. On the one hand, there will be 15 million mobile and wireless telehealth devices by 2012, says an ABI July 22 research report, devices that will be jabbering away with information about our chronic disease measurement readings. Kind of exciting, especially for those who may be home-bound or live a long (or traffic-jammed) distance from the doctor's office. But who's going to monitor their readings? Oh yeah, the current health providers (aka today's doctors and nurses in hospitals and standard practice settings).

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AHRQ Health IT Proposed Project

AHRQ-supported research has helped to demonstrate the potential of health IT to enhance health care quality and patient safety. As the lead federal research agency on the quality, safety, efficiency, and effectiveness of health care in America, AHRQ plays a central role in efforts to increase the adoption of health IT. Consistent with its mission, AHRQ proposes to develop measures of four indicators of performance of its health IT portfolio, namely: 1. Reduction in medication errors due to adoption of electronic prescribing systems; 2. The number of persons who can access their medication information online; 3. The number of clinicians who can electronically access evidence-based prevention or treatment information; and 4. The number of clinician organizations who have adopted evidence-based decision support technologies. While secondary data are available to calculate measures 1, 3 and 4 described above, no national data exist for measure 2. Thus, this proposed information collection relates to measure 2: The number of persons who can access their medication information online.

Barriers and Drivers of Health Information Technology Use for the Elderly, Chronically Ill, and Underserved

This report is based on research conducted by the Oregon Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD.

Researchers reviewed the evidence on the barriers and drivers to the use of interactive consumer health information technology (IT) by specific populations, namely the elderly, those with chronic conditions or disabilities, and the underserved.

Interactive consumer health information technology (health IT) promises to engage consumers and promote their active participation in improving their health. Interactive technologies provide health information and tools that are patient-centered, offering care and support that integrates individual needs and preferences into clinical information systems. Such technologies, by tailoring health information and delivering targeted care, have significant potential to foster patient self-care monitoring and management. As the evidence on health IT interventions increases, it is important to understand how specific target groups such as the elderly, those with chronic conditions or disabilities, and underserved populations are able to access, use, and benefit from these applications.

HHS Secretary Highlights Contributions of Health IT Advisory

The American Health Information Community (AHIC) -- a federal advisory committee established in 2005 to offer recommendations to HHS Secretary Mike Leavitt to accelerate the adoption of health information technology, or health IT -- formally concluded its work today. "When I first convened the AHIC, I envisioned a health care system that put patients first; enabled better management of patient care; improved clinical outcomes; reduced errors; and increased convenience," Secretary Leavitt said. "This type of system of connected care - where patient scan access their health information any place at any time -- offers great promise to improve not only the care of each individual but to improve the well-being of the nation as a whole. While work remains to achieve that long-term vision, I am proud of the achievements the AHIC has made to significantly advance our nation toward it."Since its inception, AHIC has brought together more than 160 public and private sector health IT experts to develop recommendations for advancing health IT. Critical to the work of the AHIC has been the contributions of seven dedicated work groups addressing diverse health IT topics ranging from patient and population needs to standards harmonization necessary to advance the use of health IT. The AHIC held 25 public meetings and 176 public AHIC workgroup meetings resulting in 200 recommendations to Secretary Leavitt that addressed a wide variety of enablers and barriers to health IT. Some of the accomplishments resulting from AHIC's recommendations include:

• The development of 26 priority areas to serve as the basis for the identification of standards, certification and networking of health information systems.
• The development of a standards-based certification process for ensuring functionality, security and interoperability in electronic health records (EHRs) supported by the Certification Commission for Healthcare Information Technology (CCHIT).
• The identification of needed outreach and incentives to spur the adoption of EHRs.
• The development of a nationwide survey methodology and analysis of the survey data using a standardized definition of adoption that will serve as the basis and future standard to assess the rate of EHR adoption in hospitals and physician offices.
• Successful live demonstrations of the Nationwide Health Information Network (NHIN).
• The establishment of a dedicated Confidentiality, Privacy and Security Workgroup that addressed the needs for clear policies and procedures to ensure that appropriate privacy and security protections are developed and maintained for the electronic exchange of health care information.

The AHIC Successor, Inc. was established in July 2008 as an independent,public-private enterprise that will bring together the public,non-profit and private sectors for the creation and use of a secure interoperable nationwide health information system. The AHIC Successor will address opportunities for action identified by the AHIC and is positioned to accelerate progress toward the development and adoption of health information technology. A new board of directors that includes three federal liaisons will begin operations in November 2008. Early efforts will focus on strategic planning and determining a prioritization process for health IT interoperability initiatives.