Electronic Health Records

The American Recovery and Reinvestment Act of 2009 (ARRA) included incentives for health care providers to adopt Health Information Technology, most notably Electronic Health Records (EHRs). There are incentive funds for both Medicare and Medicaid providers. Providers at community clinics and health centers (CCHCs) will likely benefit the most from the Medicaid EHR incentive funds. In statute, providers at Federally Qualified Health Centers are specifically listed as eligible professionals for the Medicaid EHR incentive funding, as long as they serve at least 30% “needy individuals:” patients covered by Medicaid, including those in Medicaid Managed Care, those enrolled in Healthy Families, patients receiving charity care, and individuals paying for their care on a sliding-fee scale basis. In order to be eligible to receive these Medicaid payments, “eligible professionals” at health centers will need to demonstrate that they are “engaged in efforts to adopt, implement or upgrade EHR technology.” For subsequent years, health center providers must demonstrate “meaningful use” of EHR technology. Eligible professionals may receive up to $63,750 over a six year period, covering up to 85 percent of allowable costs. Providers can access up to $21,250 for the first year to cover purchasing an EHR and an additional $8,500 for five subsequent years to cover operations and maintenance.

Providers seeking Medicare EHR Incentive funding may receive up to $44,000. Providers practicing in a HPSA are eligible for a 10 percent bonus for each year of funding.

 

Meaningful Use

CPCA has extensive information and resources regarding the EHR Incentive Program Meaningful Use requirements.  Please click here to access the Meaningful Use webpages.

 

HIT Task Force

In January, 2011, CPCA merged the EHR Meaningful Use Workgroup with the HIE Workgroup into the HIT Task Force. Please click here for information on the Task Force.

Please contact Kelley Aldrich at kaldrich@cpca.org if you would like to be added to the HIT Task Force.

If you have any questions about the comments or CPCA’s policy work on EHR and meaningful use, please contact 

 

CPCA Supporting Materials

CPCA's Comments on the Meaningful Use Preliminary Stage 3 Proposal  (January 14, 2013)

Electronic Medical Records  - CCHCs Product List from 2012 HIT-PCHH Survey (July 23, 2012)

Electronic Dental Records  - CCHCs Product List from 2012 HIT-PCHH Survey (July 23, 2012)

CPCA 2012 HIT/PCHH Survey Summary  (PDF, 520 KB)

Third Party Registration for Medicaid Eligible Providers 

CPCA Comments on CMS Stage 2 Meaningful Use Proposed Rule  - May 2012

CPCA Meaningful Use FAQs  - August 16, 2011

CPCA Comments on HIPAA Privacy Rule Accounting of Disclosures  - July 29, 2011

CPCA Comments on the electronic health record (EHR) Temporary Certification Program, Stage 1 Meaningful Use  - June 2, 2011

CPCA comments on the ONC HIT Strategic Plan  - May 6, 2011

CPCA EHR Incentives Final Rule Presentation  - March 31, 2011

Comments on Draft Stage 2 Meaningful Use Measures  - February 25, 2011

UDS/Meaningful Use Crosswalk  - December 7, 2010

CPCA Synopsis of CMS Final Rule on Meaningful Use, Stage 1 UPDATED  - November 4, 2010

EHR Loan Concept Memo  (to the California Health Facilities Financing Authority) - March 19, 2010

CPCA Proposed Rule Comments - March 15, 2010

CPCA Summary Results from HIT Survey  - August 21, 2009

Meaningful Use Incentives - Centers for Medicare and Medicaid Services

CCHIT - (EHR Certification Body)

Drummond Group - (EHR Certification Body)

InfoGard Laboratories Inc. - (EHR Certification Body)

 

Publications

The Real World Impact of Meaningful Use Blog 

CMS EHR Incentive Programs Eligibility Decision Tool for Eligible Professionals (Slideshow)

Medicare and Medicaid Electronic Health Records Incentives: Reassigning Payments , NACHC (October 10, 2010)

Optimizing HIT/HIE to Achieve Meaningful Use , Toby Douglas, Chief Deputy Director, Health Care Programs, DHCS (November 2009)

Meaningful Connections: A Resource Guide for Using Health IT to Support the Patient Centered MedicalHhome , Patient Centered Primary Care Collaborative (2009)

The Impact of Federal Stimulus Funds on Community Health Centers in California , CHCF (2009)

Health Information Technology Resources for Community Clinics , CCI (June 2009)

An Unprecedented Opportunity: Using Federal Stimulus Funds to Advance Health IT in California , CHCF (2009)

2008 HIT Survey , NACHC (2008)

State of California: Health Information Technology Financing Advisory Commission Report , CA Health and Human Services Agency (December 2008)

EHR Adoption in the Safety-Net , CHCF (February 2009)

 

 

Health Information Exchange

Health information exchange (HIE) is a central component to the meaningful use criteria associated with the Medicare/Medicaid EHR incentive funding created through the American Recovery and Reinvestment Act (ARRA). Cost savings are anticipated to be found through the exchange of health information and the efficiency this will create in our health care system. Few of California’s CCHCs have been actively participating in HIE due to cost, limitations in technology, and other factors. ARRA has stimulated a new level of engagement and commitment to HIE, and California’s CCHCs will be central players to the success of HIE in the state. The state designated Cal eConnect to be the state designated entity to oversee HIE activity in the state. There is a seat for a community clinic/health center representative on the 22-member board. To learn more about the state’s efforts and Cal eConnect, visit  http://www.ehealth.ca.gov/Governance/tabid/84/Default.aspx.

 

Announcements

Federal

The Open Library of HIE (OLHIE) is an ONC and CHHS-sponsored registry and interactive digital repository for health information exchange (HIE) related assets, and an online collaborative space designed to support the rapid development of HIEs.

OLHIE is being developed to accelerate the rate and decrease the cost of connecting with HIEs by facilitating the widespread re-use of HIE interfaces, documentation, and other assets, especially those developed with federal or state funding.  Please click here to access the OLHIE website.

ONC released new online tools to help providers and Health Information Exchange organizations (HIEs) educate patients about the electronic sharing of their health information.

Meaningful consent occurs when the patient makes an informed decision and the choice is properly recorded and maintained. ONC’s new Meaningful Consent resources provide strategies and tools that can be used by health care providers to engage and educate patients so they can make an informed decision.

As part of the resources, users will find background information about Meaningful Consent, practical implementation tips, videos, and customizable tools from ONC's eConsent Trial Project. The educational materials and tools are now available for download and customization at eConsent Toolkit.

Fostering trust in new technologies is integral to the successful adoption of health information exchange. Effectively informing patients and providing them with options for how they would like to participate are important means of fostering this trust. Read more on the new Health Affairs blog.

State

Health care providers in California and Oregon are now querying each other’s provider directories and sending interstate Direct messages as a result of the Western States Consortium project.

The Consortium’s final report details how the Office of the National Coordinator for Health Information Technology (ONC) collaborated with 13 states to successfully test ways to break down technical and policy barriers to interstate exchange.

This is one example of how the Department of Health & Human Services is encouraging interoperability across states’ electronic information infrastructures, as described in the recently released Principles and Strategy for Accelerating Health Information Exchange.

CalOHII has awarded contracts to three organizations to participate in an electronic personal health record (PHR) demonstration project. Nothing currently exists to aid health information service providers (HISPs)/health information organizations (HIOs) or providers in evaluating the suitability of PHRs for inclusion in their delivery of care. The pilot will help establish policies and procedures for identifying use cases and the specific conditions for trusted exchange that includes PHRs.  Click here for more information.

The California Association of HIEs is working to establish "light-weight self-governance" for trusted exchange in California based on a single multiparty agreement that enables all organizations to exchange information with each other and builds on Healtheway and the national eHealth Exchange.

Four voluntary workgroups are working on a range of issues, according to Dave Minch, CAHIE co-chair. A joint pilot project by CHeQ and CAHIE is underway to develop the technical and policy on-boarding and governance documents and processes. Seven organizations have signed up for the pilot.

"The DURSA parsing workgroup is about to complete its work on the DURSA decomposition which we are planning on sending to HealtheWay to help them with their development process," Minch said. "The DURSA parsing group's current task is surveying existing bilateral agreements in the state to find common terms and elements which along with the DURSA decomp will form the body of the CA DURSA."

 

Current Advocacy

HIT Task Force

If you have any questions about the comments or CPCA’s policy work on EHR and meaningful use, please contact 

Resources

 

Websites

Cal eConnect

California eHealth Collaborative

Connecting for Health: Markle Foundation

California Office of Health Information Technology (CalOHI)

 

CPCA Materials

CPCA comments on CalOHII HIE Demonstration Project Regulations - March 31, 2011

CPCA Letter to CalPSAB regarding HIE Consent - December 6, 2010

CPCA Comments on Cal eConnect RFIPC - October 5, 2010

Abridged version- Cal eConnect Request for Information and Public Comment on the Technical Implementation Plan for Core HIE Service, September 14, 2010

California

Telehealth

California’s CCHCs have long utilized a variety of telehealth tools to deliver care to their patients. Telehealth provides an efficient means to connect patients and providers, patients to health equipment monitored by health care providers, providers to learning opportunities, and general connectivity.

Resources

California Telehealth Network (CTN), http://www.caltelehealth.org/.  CTN works with the California Telehealth Resource Center (CTRC), previously known as the California Telemedicine and eHealth Center (CTEC), to expand telehealth training and support for rural and medically underserved clinics and hospitals in California.

Center for Connected Health Policy, http://cchpca.org/.  CCHP offers tools, materials, and technical assistance on telehealth policy. 

Frequently Asked Questions

CPCA created a FAQ on telemedicine billing that was reviewed by the Department of Health Care Services. To view the FAQ, contact Ginger Smith, gsmith@cpca.org.

 

CPCA Staff Contact

If you have any questions, or need more information, please contact