Beyond the Stage 1 Criteria for Meaningful Use

The policy goals of meaningful use will be most fully realized by building on findings from Stage 1 and by making full use of the greater proliferation of certified EHR technology and supporting HIT infrastructure that will take place under Stage 1.  CMS intends to propose through future rulemaking two additional stages of the criteria for meaningful use.

Stage 2 would expand upon the Stage 1 criteria in the areas of disease management, clinical decision support, medication management, support for patient access to their health information, transitions in care, quality measurement and research, and bi-directional communication with public health agencies.   CMS may consider applying the criteria more broadly to both the inpatient and outpatient hospital settings. 

Consistent with other provisions of Medicare and Medicaid, Stage 3 would focus on achieving improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self management tools, access to comprehensive patient data, and improving population health outcomes.

Additional information can be found at www.cms.hhs.gov/Recovery.

CMS provides a 60-day comment period on the proposed rule.  The proposed rule may be viewed at http://www.cms.hhs.gov/Recovery/11_HealthIT.asp.

Notice "support for patient access to their health information" happens in stage 2 of the meaningful use criteria.

Good news, it's included in some capacity...and this gives all of us consumer-centric co's time to build.

Bad news, the NHIN will march onward focused on stage 1, which means we'll be scrambling for simplification when it comes time to integrate patient capabilities to access data.

Buckle your seatbelts boys and girls - it's gonna be a loooong trip to 2013....

"If you eat too much, exercise too little, drink too much, smoke, take drugs, fail to wear a seat belt, or ignore gun safety, there's only so much a doctor or hospital can do for you.

And Americans do all those things, more than other people. And many are uncomfortably aware that self-destructive behavior is most often found among the poor and among minorities.

Public policy can achieve only a limited impact against these problems. We'll have to rethink the deeper structure of American food policy: subsidies to corn and soybean growers, the paving over of exurban land that might provide nearby cities with less expensive fruits and vegetables.

Ultimately, though, these are decisions that individuals must make for themselves.

The present concept of medicalized health care sends some unwelcome messages. By outsourcing the concept of health as something that doctors, hospitals, and now government do for you -- rather than something that depends considerably on your own choices and efforts -- we ask the medical system to do more than any medical system can do.

As you consider your new year's resolutions, remember: better habits will benefit not only your family and yourself -- but all your neighbors and countrymen as well."  

From: "Wednesday, December 30, 2009 | DCPCA Health News Alert."

At the Body Computing conference we explore ways to expand the ability of technology to deliver information to consumers and get better outcomes. Can you put entertainment in? With the Internet, the draw is entertainment, and that can be very motivating. So the Beating Heart is totally for your kid to play with. You stick a patch that looks like this cool glowing heart on your chest, and it communicates the heart rate to the phone. It gives kids insight into what the heart rate is. They can send a photo of the latest teen idol and see what effect it has on their friend's heart rate. We will have increasing capability of monitoring ourselves this way.

From: "Implant Wizard - Health Data Management."

Fall 2010.

The CMS offers patients with LTCs the chance to benefit from ‘pharmaceutical care planning’ with their community pharmacist as well as shared care and repeat dispensing.

When a patient signs up for the CMS the pharmacy’s patient medication record will send an electronic notification to the GP’s IT system which then allows the GP to choose whether to enter into a shared care agreement with the option to generate serial prescriptions for up to 48 weeks.

The pharmacist draws up a pharmaceutical care plan with the patient and if a shared care agreement is in place relevant information shared between the pharmacy and the GP with informed patient consent. At the end of the serial prescription time period the pharmacist sends an electronic end of care treatment summary and a request for a new serial prescription.

From: "E-Health Insider Primary Care :: Scotland's CMS to go national in April."

"What if I told you that Juan, a community health worker in rural Ecuador, is providing injectable contraceptives outside the clinic setting to indigenous community members?

What if I told you that Juan is actually 15-years-old and the clients he's reaching are also youth?

Juan and 30 other young people, aged 11-19, are the first group of peer promoters to use a peer-to-peer community based model to deliver injectables and other contraceptives to rural and indigenous youth in the Chimborazo region of central Ecuador.

The program is born of a partnership between Planned Parenthood Federation of America (PPFA) and CEMOPLAF, a major Ecuadorian reproductive health NGO.

Ecuador has the highest adolescent fertility rate in Latin America, and this skyrockets when we're talking about rural or indigenous youth. Among community members in the region here, just 6 percent of women and 12 percent of men reported contraceptive use, while less than half of all women reported any knowledge of sexually transmitted infections (STIs).

This program meets the needs of a particularly underserved and hard-to-reach group, with a new contraceptive method, in a new way.

The peer promoters hail from 15 different small communities within the region and are providing a brand new range of services to their peers. They meet weekly at a central clinic location to discuss challenges and attend trainings. There, CEMOPLAF also provides lunch, transportation costs and job-skills training."

 

 

Absolutely fascinating program.

Another socially contagious approach to public health. This time, it's teens literally innoculating each other against STDs.

Obesity is becoming more common among poor city dwellers in Africa because of easier access to cheap, high fat, high sugar foods, scientists said.

Researchers looking at data from seven African countries found the number of people overweight or obese increased by nearly 35 percent between the early 1990s and early 2000s and the rate of increase in obesity was higher among poor people.

"Given the chronic nature of most diseases associated with obesity and by extension the huge cost of treatment, the prospects look grim for the already under-funded and ill-equipped African health care systems unless urgent action is taken," said Abdhalah Ziraba, who worked on the research with the African Population and Health Research Center in Nairobi.

From: "Global Health Council - Studies Show Obesity Taking Hold in Africa and ."

I wonder how long we have until obesity will be the number one cause of death worldwide?

When physician respondents were asked how concerned they are “about losing the unique patient story with the transition to point-and-click (template-driven) EHRs,” 96 percent voiced concern, reinforcing the need for patient health records to be created using a combination of structured and narrative information.

From a Nuance study of almost 1k docs.

Fascinating. Those who've seen the Contagion platform stuff - ahem. :) Right track, ho!

A hospice nurse who handed homemade cookies to her operating team. A retired stockbroker who had volunteered with the National Kidney Foundation and decided to walk the talk. And a woman inspired by President Barack Obama's call to volunteer. They all donated a kidney with nothing to gain - they didn't have a friend or loved one in the marathon chain of transplants that they helped make possible.

"It feels wonderful," Sylvia Glaser, 69, the hospice nurse, said Tuesday at a news conference where most of the donors and recipients met for the first time. "You are giving someone a life, and there is no substitute for that."

"It's not like I'm doing anything courageous," Bill Singleton, 62, the kidney foundation volunteer, told The Associated Press before his surgery. "If I don't volunteer, who will?"

From: "Patients meet donors from largest-ever kidney swap."

Sometimes you despair about the future of healthcare reform and healthcare delivery in general...

And then you read about something like the largest 'step' or 'stair' kidney transplant, done at Georgetown.

13 people giving of selves on a level you and I can't even begin to contemplate.

Tis the season people. Do something good with your resources, anatomical and otherwise.