The document discusses the Health Information Technology for Economic and Clinical Health Act (HITECH), which provides incentives for healthcare providers to implement electronic medical records (EMRs) and demonstrate meaningful use of EMRs. It outlines requirements for certified EMRs and meaningful use, and recommends that healthcare organizations create teams to develop strategies for implementing EMRs in compliance with evolving regulations.

1. Electronic Medical Records & HITECH Lyon, Popanz  Forester May 7, 2009 An exploration of an evolving regulatory environment

2. There's another acronym in town: HITECH The Health Information Technology for Economic and Clinical Health Act It is part of the American Recovery and Reinvestment Act of 2009 or "the stimulus package“

3. Basically: Provides incentives to hospitals and doctor's offices to move to electronic medical or electronic health records (EHR) There are incentives to and penalties for failure to: Use a “certified” EHR: Demonstrate “meaningful use” of an EHR:

4. Use a “certified” EHR The act does not specify what “certification” will mean or who will provide certification. What the act does specify is the technology must include patient demographic and clinical health information and have the capacity to provide clinical decision and physician order entry.

5. Demonstrate “meaningful use” of an EHR Health and Human Services (HHS) will be defining what “meaningful use” means in the year ahead. The following conditions for “meaningful use” have already been identified. The EHR must: Use e-Prescribing: This means that the EHR must allow physicians to prescribe over the Internet. Electronically exchange information: The ability to exchange clinical information with labs, hospitals, providers, and payers including Medicare and Medicaid Submit clinical quality measures: including payer-specific quality measures

6. Been here before At this point there is only: Vague direction A target date: 5 years Uncertainty Recent similar circumstances HIPAA Y2K Mergers

7. Getting started Get a structure in place to find and track information and move toward the certainty required for action Define “now” because that is the place you will have to start Develop a “living” strategy or master plan

8. Getting Started Create a team to focus and define: Scope for EMR at your hospital or clinic External status: regulatory, standards, vendor solutions, sources of support … Internal status: records processes, systems, infrastructure, plans … “ Success” for your organization High level strategy for organization, planning and budgeting

9. Likely strategy elements Managed by a project office for control, flexibility and visibility Implemented in phases for cost/benefit Vendor system and/or services to take advantage of proven solutions to common problems Interface intensive to serve all stakeholders Database driven – data intensive System and data security critical

10. The Team Chaired by a senior executive Patient care representatives including nurses and doctors Records management Systems HR Compliance Security Process manager familiar with similar complex, vague and time driven projects

11. We work in the white space of organizations … including HIPAA, Y2K , mergers and the implementation of evolving regulations The white spaces of organizations occur on organization charts between internal departments, in contractual ambiguity and regulatory complexity. They are places where functional misunderstandings occur, communication falters, roles change, priorities conflict, rewards are unclear, risks are unknown, and managers sometimes see threats to their careers that outweigh the opportunities. We work in those white spaces to define problems so they can be solved, design solutions so they can be implemented, and structure implementation so it can be managed. Hal Amens [email_address]