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Thursday, January 21, 2016
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Over 200,000 Professionals will See Decrease in Medicare Payments for Failing to Meet MU Standards
A fact sheet recently released by the Centers for Medicare and Medicaid Services revealed more than 200,000 medical and healthcare professionals will see a decrease in Medicare reimbursement after failing to meet 2014 Meaningful Use standards. According to CMS, at this point "more than 70 percent of EPs and other clinicians and more than 95 percent of eligible hospitals have successfully used electronic health records and received incentive payments from the federal government." Despite this success, the program continues to draw fire from healthcare professionals that believe the recent legislation signed by the President allowing additional flexibility for hardship exemptions reveals that the program’s time has ended. In a tweet dated January 11, CMS Acting Director, Andy Slavitt, indicated that Meaningful Use as it stands is effectively over and is being replaced with something better.
The end of the current Meaningful Use program is due to the forthcoming changes indicated in the Medicare Access & CHIP Reauthorization Act of 2015.
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Increasing Data Breaches Adversely Affect Healthcare
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A recent study performed by IT firm, Akarmai, revealed that in the third quarter of 2015, distributed denial of services (DDoS) attacks rose across all sectors of the economy. A rise in attacks means a logical rise in concern for the healthcare industry. The increase of 23 percent from Q2 to Q3 2015 pales in comparison to the increase from Q3 2014 to Q3 2015 of nearly 180 percent. DDoS is where a hacker prevents an authorized computer user from being able to access critical information. In the healthcare setting, DDoS attacks take the form of attackers compromising an EHR, impeding providers from accessing the records in a timely manner. While the frequency of attacks rose, the report reveals a positive note that the duration of attacks fell due to increased security measures.
Attackers commit the crimes by a few different methods. The most prevalent is the phishing fraud, a known threat that industry has responded to by educating providers. In a phishing scam, “The victim is an unwitting accomplice in the attack. The attacker’s query is spoofed to appear to originate from the attacker’s target. The attacker uses an automated attack tool to send malicious queries at high rates to a large list of victims, who will in turn respond to the target,” Akamai reports. Other ways DDoS attackers hack computers is through malware and cloud hacking tools, such as the Cloudpiercer.
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Upcoming Events:
REGISTER NOW for eHI's 2016 Annual Conference, February 3-4 at the House of Sweden in Washington, DC
Faces of eHI:
Q&A with Brian Kelly, President, Payer & Provider Solutions, Quintiles
Member Spotlight:
Teladoc Conducted 575,000 Remote Visits Last Year
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Twitter Provides Patient Perspective on Errors
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According to a new study highlighted in the Journal of Patient Safety, Twitter can serve as a tool to assist providers in collecting data on medical errors and improve patient communication and engagement. In the study, the head researcher, Atul Nakhasi, and his team took advantage of Twitter’s search program interface to collect tweets ranging from January to August 2012. They analyzed over 1,000 tweets to identify those that contained certain key phrases, such as “doctor screwed up.” Researchers found 83 percent of the tweets specified the type of medical error. In that 83 percent,
- 23% were for diagnostic errors;
- 23% were for medication errors; and
- 14% were for surgical errors.
Additionally, the team also examined emotional response in roughly 50 percent of the tweets collected, revealing the following:
- 47% expressed anger or frustration;
- 21% expressed humor or sarcasm; and
- 14% expressed sadness or grief.
According to the researchers: “Twitter is a relevant data source to obtain the patient perspective on medical errors.” They add that Twitter can also “provide an opportunity for health systems and providers to identify and communicate with patients who have experienced a medical error.”
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State Medicare Policies Regarding Telemedicine Impact Use of Services
Policies in the various states regarding telemedicine use under Medicare can have a great impact on the adoption of technology, at least according to a recent study in Telemedicine and e-Health. The authors of the paper found that after Michigan enacted commercial payer parity for telemedicine in 2012, the state saw an increase in Medicare telemedicine use only a year later. Michigan saw an increase of 77.5 percent for encounters and 118.4 percent in Medicare fees from 2012 to 2013. Illinois also saw a rise in the telemedicine use rate two years after Medicare expansion adoption. Ohio and Pennsylvania, two states who did not adopt new policies for the use of technology, continue to see low levels of telemedicine use, according to the study. Authors add, "findings can likely be attributed, at least in part, to the fact that increasing the number of payers or covered services for a telemedicine program increases the program's viability. Programs limited to seeing patients from a single payer are likely to be less scalable or financially sustainable, depending on the total market share of payers with positive telemedicine reimbursement policies.”
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ONC Task Force Requests Information on Developing EHR Comparison Tool
Earlier this month, the Office of the National Coordinator for Health IT's new certified technology comparison task force held two meetings - an in-person meeting and a virtual hearing. The goal is to create draft recommendations on a tool that can compare EHR systems. This task force believes that the tool can prove useful for providers making their first EHR purchase, along with those considering modular component purchases. It also can help determine products that are in the market to inform further purchases. The current crop of tools fails to include cost comparisons, interoperability, or workflow and safety usability. Additionally, members expressed concern over EHR vendor gag clauses that impede the free flow of information between products of rival vendors.
The task force heard testimony from many experts including Lori Simon, MD from the American Psychiatric Association's Mental Health Information Technology Committee. Dr. Simon testified that very few current EHRs support the needs of the mental health community and that there is currently no mechanism to guide providers in selecting technological services.
The task force is expected to finalize its recommendations and present to ONC’s HIT Policy and Standards Committee this week.
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FDA Introduces Cybersecurity Recommendations for Medical Device Manufacturers
Last week, the Food and Drug Administration released a 25-page guidance for device manufacturers to adopt a cybersecurity risk management system that meets federal standards. One of the requirements released encourages manufacturers to apply benchmarks illustrated in a 2014 National Institute of Standards and Technology report. The NIST report, “Framework for Improving Critical Infrastructure Cybersecurity,” came from Executive Order 13636, which promulgates a cybersecurity framework to follow when managing a cybersecurity risk: identify, protect, detect, respond, and recover. Critical parts of a compliant program include:
- Monitoring cybersecurity information sources for identification and detection of cybersecurity vulnerabilities and risk;
- Understanding, assessing and detecting presence and impact of a vulnerability;
- Establishing and communicating processes for vulnerability intake and handling;
- Clearly defining essential clinical performance to develop mitigations that protect, respond and recover from the cybersecurity risk;
- Adopting a coordinated vulnerability disclosure policy and practice; and
- Deploying mitigations that address cybersecurity risk early and prior to exploitation.
In a press release, the FDA states “Cybersecurity threats to medical devices are a growing concern. The exploitation of cybersecurity vulnerabilities presents a potential risk to the safety and effectiveness of medical devices. While manufacturers can incorporate controls in the design of a product to help prevent these risks, it is essential that manufacturers also consider improvements during maintenance of devices, as the evolving nature of cyber threats means risks may arise throughout a device’s entire life-cycle.”
“All medical devices that use software and are connected to hospital and health care organizations’ networks have vulnerabilities—some we can proactively protect against, while others require vigilant monitoring and timely remediation,” said Suzanne Schwartz, MD. Schwartz is the Associate Director for Science and Strategic Partnerships and an Acting Director with the FDA’s Center for Devices and Radiological Health.
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Dr. Vindell Washington Joins ONC as Principal Deputy National Coordinator!
On January 25, Dr. Vindell Washington will join the Office of the National Coordination for HIT as Principal Deputy National Coordinator. ONC’s Dr. Karen DeSalvo announced the appointment in an email Tuesday morning.
Dr. Washington most recently served as the President of the Franciscan Missionaries of Our Lady Health System (FMOLHS) Medical Group and as the health system’s Chief Medical Information Officer. At FMOLHS, Dr. Washington led over 500 physicians, advanced practitioners and 1,400 employees in more than 70 care locations, with a focus on transforming ambulatory care delivery models.
Dr. Washington received a B.S. from Pennsylvania State University, an M.D. from the University of Virginia, and an M.S. in Healthcare Management from the Harvard University School of Public Health. He is board certified in Emergency Medicine and a Fellow of the American College of Emergency Physicians.
At HHS, Dr. Washington will provide executive direction and leadership for all ONC programs, operations, and policies. He will endeavor to advance key Administration initiatives, such as delivery system reform, the Precision Medicine Initiative, and implementation of the Interoperability Roadmap.
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