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July 24, 2008
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CCHIT Approves Inpatient, ED and Enterprise EHR Criteria

The Certification Commission for Healthcare Information Technology (CCHIT, Chicago) has published its approved final criteria for certification of inpatient and emergency department EHR products and enterprise EHR certification for vendors providing interoperable ambulatory, inpatient, and ED records.

The first round of applications for certification under the new 2008 criteria will be accepted August 1-14, with certified products expected to be announced in November. The final certification criteria, test scripts and associated program policy documents can be accessed on the Commission's Web site.

Harvard Study: Mortality Lower in Leapfrog Hospitals

According to a study from the Harvard School of Public Health, hospitals that perform well on the Washington-based Leapfrog Hospital Survey have lower mortality and better quality of care than those who either didn't perform as well on the survey or who chose not to complete the survey.

Researchers used the 2006 Leapfrog Hospital Survey and the 2006 Hospital Quality Alliance data to make findings about three common conditions – acute myocardial infarction (AMI), congestive heart failure (CHF) and pneumonia.

According to the company, hospitals that had begun to implement Leapfrog safety practices also had lower mortality rates.

Study: Top Hospitals Earning $7 Million

The 112 top-performing hospitals earned a total of $7 million in incentive payments for substantial and continual advancement in quality of care, according to the latest results of the Premier Hospital Quality Incentive Demonstration (HQID), which demonstrate across-the-board improvement in the performance of participating hospitals.

Launched in October 2003 by the Centers for Medicare & Medicaid Services (CMS) and the Premier Inc. healthcare alliance, HQID, the demonstration was designed to test new payment systems under Medicare that would improve the safety, quality and efficiency of care delivered in the nation's hospitals.

Fifteen hospitals moved from “worst to first” rankings, advancing from the bottom to the top fifth of hospitals in one or more clinical areas. These hospitals improved by an average 32.6 percentage points in quality scores over three years, say the organizations.

Study: Docs Not Adopting EHRs

Only 4 percent of physicians have a fully functional EHR system and 13 percent have a basic one, according to a study in the June 19 online edition of the New England Journal of Medicine.

The survey of 2,758 physicians — authored by David Blumenthal, M.D., director of the Institute for Health Policy at Massachusetts General Hospital and Catherine DesRoches, an assistant in health policy at Massachusetts General — shows that 16 percent of physicians had purchased an EHR but not employed it, while 26 percent planned on buying one within the next two years.

The authors define a fully functional EHR as one that has a broad range of capabilities including order entry and clinical decision support. A basic EHR is one with a minimum set of functionalities such as recording laboratory data and clinical notes, and electronic prescribing.

According to the study, EHR use is much more prevalent among younger physicians, primary care physicians, and physicians in larger practices, hospitals and medical centers, and is more widespread in the Western part of the United States. Two-thirds of physicians without EHRs cited affordability as the reason. Other reasons included finding the right EHR, concern about return on investment, and that the system will become obsolete quickly.

Physicians who use electronic records report being satisfied, with large majorities saying it helped improve the quality of clinical decisions, helped them communicate more effectively with other providers, and facilitated prescription refills and avoidance of medical errors. Having a full electronic record also had positive effects on the delivery of chronic and preventive care, helped doctors avoid problematic medication interactions, and promoted more efficient ordering of critical lab tests, they indicated. One in five physicians expressed reservations about ease of use and reliability of their systems.

According to the authors, further adoption may be enhanced by helping doctors buy an EHR either through loans, incentive programs, or directly paying them, as well as protecting them from personal liability for record tampering by external parties.

Healthcare Informatics 2008 August;25(8):68

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