March 31, 2014

The NIST Folks Chime-In on EHR Workflow and Usability

Filed under: CMS,EHR Incentive,Meaningful Use — Tags: , , — HankMayers @ 10:27 am

The National Institute of Standards and Technology (NIST) was directed by Congress to work with the ONC on the CHERT certification process as well as generally advise on the EHR effort. Given their background on the application of advanced technology, it is good to hear from them. Their findings reinforce much of what EHR implementers experience every day. One only hopes that the ONC can help champion this work in some fashion, and that the vendor community does not miss these considerations as they scramble to meet 2014 and 2015 CHERT changes.

While it is great to have the NIST credibility behind this topic, I have only one beef with their work; An organization with as broad a scope as they have, isn’t it about time that this analysis include a strong focus on mid-levels and other practitioners, who also must make considerable use of the EHR? With the advent of the PCMH, the significance of their use of the EHR is continuing to rise, and how the EHR enhances the staff integration of knowledge and activity is a key consideration.

If the NIST folks elect to perform a similar analysis of the INPATIENT world (which I hope they do), nurses, techs, and other classes of patient-serving folks are heavy users of EHRs in their own right.

One final observation: CMS’ ambulatory workflow in their DOCIT effort should have been included in the NIST research.

Thoughts anyone??

March 22, 2014

Federal HIT Policy Committee Advises that MU3 Objectives Be Reduced By 8

Filed under: EHR Incentive,EMRs,Meaningful Use — HankMayers @ 8:15 pm

At its March 11, 2014, the HIT Policy Committee to the ONC recommended that the number of objectives for Stage 3 be reduced by nine (9). The objectives that they believe should be removed include the following:
• Reminders via patient preference
• Handling patient requests for amendments to their record
• eMARs
• Automated Case Reports for the CDC
• Medication Adherence- tracking what is actually administered
• Syndromic Surveillance by EPs
• Access to Images
• Recording Family History

These changes leave the following as recommended Stage 3 MU Objectives:

Improving Quality of Care & Safety
1. Clinical Decision Support
2. Order Tracking
3. Demographics/patient information
4. Care planning – advance directive
5. Electronic Notes
6. Hospital labs
7. Unique device identifiers

Engaging Patients & Families in Their Care
8. View, download, and transmit records
9. Patient generated health data
10. Secure messaging
11. Visit summary/clinical summary
12. Patient Education

Improving Care Coordination
13. Summary of Care at transitions
14. Notifications
15. Medication Reconciliation

Improving Population & Public Health
16. Immunization history
17. Registries
18. Electronic lab reporting
19. Hospital syndromic surveillance

Next step: ONC final decision-making and the Publication of final NPR

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