David Kibbe has an insightful take on 'meaningful use'. He posits that all we need to do is specify open interoperability standards (and NOT specify applications).
http://www.thehealthcareblog.com/the_health_care_blog/2009/04/by-david-c-kibbe-and-brian-klepper------one-of-the-important-decisions-before-dr-blumenthal-and-his-colleagues-at-onc-and.html .Mark On Wed, Apr 22, 2009 at 9:21 PM, fred trotter <fred.trot...@gmail.com> wrote: > Hi, > As I mentioned before I have been asked to testify at the NCVHS > Hearing on Meaningful Use. As far as I know I am the only FOSS > representative there (although I know that Dr. Billings from Medsphere > is planning on attending, can anyone else make it?) > > I have just received more specific questions from the NCVHS. > > Please use this thread to discuss these points inline. Also please > recognize that I am specifically representing FOSS as opposed to > Health IT generally, so making general points does not help me as much > as making specific points about what implications FOSS > community/licenses/process has for a question. > > Regards, > > -- > Fred Trotter > http://www.fredtrotter.com > > NCVHS Hearing on Meaningful Use > April 28-29, 2009 > Question for Panel Input > > > Panel 1: Vision of Health and Health Care Transformed > > 1. What are the critical characteristics and enablers of a safe, > patient-centric, high-quality health care system that optimizes > patient outcomes? > > 2. What have been the major barriers to system-level improvement in > the health care system? > > 3. How can incentives programs best be structured to support health > reform? > > > Panel 2: Meaningful Use Capacity/Functionality in EHRs > > 1. What EHR capacities/functionalities are absolutely required to > enable a safe, patient-centric, high-quality health care system that > optimizes patient outcomes? > > 2. What are the critical EHR functionalities (e.g., e-prescribing, > decision support, problem list management) of which providers should > be required to demonstrate use in order to be earn an incentive as a > “meaningful user” of certified EHR technology in 2011? Should the > functionalities or other specific requirements to meet the statutory > “meaningful use” criteria be different or specific to provider type > (i.e., eligible professionals, hospitals)? > > 3. Are these functionalities supported in current certified EHR > products? If not, what are the gaps? > > 4. What additional functionalities would be most important to require > providers use by 2014 or 2015? > > > Panel 3: Meaningful Use Capacity/Functionality in Health Information > Exchanges > > > 1. What are the ways in which health information exchange enables a > safe, patient-centric, high-quality health care system that optimizes > patient outcomes? > > 2. What will the health information exchange landscape look like in > 2011 (e.g., penetration of operational HIOs, e-prescribing networks), > and how would that enable or constrain meaningful information exchange > requirements? > > 3. What would be the trajectory over time of increasingly robust > requirements for information exchange as more opportunities for > exchange become available? > > 4. How might the incentives criteria be constructed so as not to > penalize providers in areas not serviced by HIOs, and how would this > change over time? > > > Panel 4: Meaningful Use Capacity/Functionality in Quality Reporting > > > 1. What are realistic goals for certified inpatient and ambulatory > EHRs to achieve with respect to capture, retrieval, and reporting of > data needed for quality measurement and informed clinical decision > making in 2011? > > 2. What is the trajectory over time toward a “quality data set” to > enable broader standardization of electronic data capture and > reporting with EHRs needed to support clinical care and quality > measurement? Describe the end goal and any interim milestones, > barriers and enablers? > > 3. What other infrastructure or policy requirements need to be > considered for HHS to enable and prepare for the sharing of electronic > data for quality measurement? > > 4. Insofar as quality measures reporting using EHRs would be to State > or Federal agency designated repository, what if any potentially > practical mechanisms or other implications for assuring accuracy, > validity, and privacy of submitted data should be considered? > > > Panel 5: Path to Meaningful Use Capacity for Vendors > > 1. What is the “time to market” cycle from adoption of standards to > installation across the client base? How does that enable or > constrain criteria for 2011 for eligible professionals? Hospitals? > Later years? > > 2. What are vendors’ expectations with respect to increased product > demand in 2011 and after, and how do they expect to meet it? What are > potential risks (for example, need for additional technical support to > assure successful implementations) and how can they be mitigated? > > 3. How will vendors need to adapt their product development and > upgrade cycles to synchronize with progress toward increasingly robust > requirements for meaningful use, information exchange, and quality > reporting? > > 4. What changes are anticipated in the vendor marketplace between now > and 2016 as a result of the incentives? > > > Panel 6: Path to Meaningful Use Capacity for Providers > > 1. What do providers see as the critical EHR functionalities to enable > a safe, patient-centric, high-quality health care system that > optimizes patient outcomes? > > 2. What are the critical success factors needed for robust > participation in the incentive programs by eligible professionals in > 2011? By hospitals? What factors would promote continued > participation in later years? > > 3. What are provider perspectives on potential barriers to health IT > adoption and what are their major concerns? What education and tools > could mitigate them? > > 4. Are there specific anticipated impacts on small providers? Rural > providers? Providers with significant Medicaid populations? Early > adopters? > > 5. How will providers need to adjust their business processes and > product refresh/version upgrade cycles to adapt to the requirements > over time? > > > Panel 7: Meaningful Use and Population/Public Health > > 1. What is your vision of population/public health practice in an era > when the health care of all Americans is supported by EHRs? > > 2. What high priority population/public health data needs can be > advanced by EHR functions and health information exchange? > > 3. What specific requirements for meaningful EHR use, including > information exchange, will most significantly benefit population > health? > > 4. How can public and population health needs/requirements translate > into meaningful use criteria that are practical to implement for 2011? > How might they affect or be affected by the path to 2016 and beyond? > > > Panel 8: Path to Meaningful Use Capacity for CMS, States, Other Payors > > > 1. What are the most important policy issues associated with > implementing the Medicare and Medicaid incentives programs (e.g., > setting 2011 criteria high enough while still assuring widespread > participation)? > > 2. What are the challenges associated with coordinating meaningful use > policy and operations across Medicare and Medicaid in 2011 and as > requirements become more robust over time? > > 3. What are the critical success factors associated with provider > participation in the incentives programs, in 2011 and later years? > > 4. How will other health plans be affected by the incentives programs, > and how can they contribute to increased meaningful use? > > 5. What is the role of states in promoting meaningful use of health IT? > > > Panel 9: Certification and Meaningful Use: EHR Product Certification > > 1. What role does certification, in general, play in promoting > meaningful use? > > 2. What are the strengths and weaknesses of the current CCHIT > certification processes, particularly as they relate to the promotion > and measurement of meaningful use? > > 3. How do the statutory requirements of ARRA/HITECH change how we > should think about certification? > > 4. How should the certification process work in 2011, and how should > it develop over time in support of increasingly robust requirements > for meaningful users in 2016 and later? > > 5. In an ideal circumstance, would multiple Secretarially recognized > certification programs or bodies be available? > > > Panel 10: Measuring Meaningful Use > > > 1. What are the strengths and limitations of the various methodologies > provided in the statute for demonstrating meaningful use (attestation, > submission of claims with appropriate coding, survey, reporting of > quality measures, or other means)? Based on this, what are the most > feasible and reliable measurement methods to ascertain compliance with > these requirements for meaningful EHR use and associated incentives? > > 2. The third criterion for a provider to be determined to be a > meaningful user is the reporting of quality measures using EHRs. > What, if any, additional standards are needed to enable providers to > report and CMS/States to successfully accept quality measures from > EHRs? Are the needs different for measures applied to different > settings (e.g. hospital or physician office)? > > 3. 3. How could the various methodologies be combined to establish an > implementable mechanism for 2011, as well as a trajectory to enhanced > reporting and accountability over time? > > 4. What mechanism would be most appropriate (e.g., electronic > mechanisms, least burdensome, most precise, etc.) to measure and > verify a provider’s use of EHR functionality and conduct of > information > > > ------------------------------------ > > Yahoo! Groups Links > > > > -- Mark Spohr, MD ------------------------------------ Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/openhealth/ <*> Your email settings: Individual Email | Traditional <*> To change settings online go to: http://groups.yahoo.com/group/openhealth/join (Yahoo! 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