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Notes | 2015 Update to Congress on the Adoption of Health Information Technology

1 ONC follows the IEEE definition of interoperability as the ability of systems to exchange and use electronic health information from other systems without special effort on the part of the user. Accessed from: http://www.ieee.org/education_careers/education/standards/standards_glossary.html

2 Centers for Medicare & Medicaid Services. Medicare and Medicaid Programs; Electronic Health Record Incentive Program-Stage 3 and Modifications to Meaningful Use in 2015 Through 2017. 42 CFR parts 412 and 495. 2015. Federal Register. https://www.federalregister.gov/articles/2015/10/16/2015-25595/medicare-and-medicaid-programs-electronic-health-record-incentive-program-stage-3-and-modifications

3 Health and Human Services. 2015 Edition Health Information Technology (Health IT) Certification Criteria, 2015 Edition Base Electronic Health Record (EHR) Definition, and ONC Health IT Certification Program Modifications. 45 CFR part 170. Federal Register. 2015. https://www.federalregister.gov/articles/2015/10/16/2015-25597/2015-edition-health-information-technology-health-it-certification-criteria-2015-edition-base

4 Charles D, Swain M, Patel V. Interoperability among U.S. Non-federal Acute Care Hospitals. ONC Data Brief, No. 25. Office of the National Coordinator for Health Information Technology: Washington DC. 2015. Accessed December 2015. http://www.healthit.gov/sites/default/files/briefs/onc_databrief25_interoperabilityv16final_081115.pdf

5 Patel V., Barker W. & Siminerio E. (October 2015). Trends in Consumer Access and Use of Electronic Health. ONC Data Brief, no.30. Office of the National Coordinator for Health Information Technology: Washington DC. Accessed December 2015. http://dashboard.healthit.gov/evaluations/data-briefs/trends-consumer-access-use-electronic-health-information.php

6 United States Government Accountability Office. Non-federal efforts to help achieve health information interoperability. Accessed November 2015. http://www.gao.gov/assets/680/672585.pdf

7 Burwell SM. Setting value-based payment goals--HHS efforts to improve U.S. health care. N Engl J Med. 2015;372(10):897-9. Burwell, 2015. Available at: http://www.nejm.org/doi/full/10.1056/NEJMp1500445

8 Health and Human Services. HHS announces $685 million to support clinicians delivering high quality, patient-centered care. September 2015. Accessed December 2015. http://www.hhs.gov/about/news/2015/09/29/hhs-announces-685-million-support-clinicians-delivering-high-quality-patient-centered-care.html

9 Health and Human Services and Centers for Medicare & Medicaid Services. Medicare and Medicaid Programs; Modifications to the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program for 2014 and Other Changes to the EHR Incentive Program; and Health Information Technology: Revisions to the Certified EHR Technology Definition and EHR Certification Changes Related to Standards. 42 CFR part 495 and 45 CFR part 170. https://www.federalregister.gov/articles/2014/09/04/2014-21021/medicare-and-medicaid-programs-modifications-to-the-medicare-and-medicaid-electronic-health-record

10 Centers for Medicare and Medicaid Services. Request for Information Regarding Implementation of the Merit-Based Incentive Payment System, Promotion of Alternative Payment Models, and Incentive Payments for Participation in Eligible Alternative Payment Models. 42 CFR 414. 2015.

11 Office of the National Coordinator for Health IT; Enabling Privacy. Accessed December 2015. https://www.healthit.gov/providers-professionals/enabling-privacy

12 Office of the National Coordinator for Health IT. Cybersecurity: A shared responsibility. Accessed December 2015. https://www.healthit.gov/providers-professionals/cybersecurity-shared-responsibility

13 National Institute of Standards and Technology. Framework for Improving Critical Infrastructure Cybersecurity. Version 1.0. 2014. Accessed December 2015. http://www.nist.gov/cyberframework/upload/cybersecurity-framework-021214.pdf

14 Office of the National Coordinator for Health IT. Top 10 Tips for Cybersecurity in Health Care. Accessed December 2015. http://www.healthit.gov/providers-professionals-newsroom/top-10-tips-cybersecurity-health-care

15 Any EHR: Physicians indicated that their reporting location used electronic medical records, not including billing record systems

16 Certified EHR: Physicians indicated that their reporting location used an EHR, and that EHR being used at the reporting location met the criteria for Meaningful Use

17 Heisey-Grove D, Patel V. Any, Certified, or Basic: Quantifying Physician EHR Adoption. ONC Data Brief, No. 28. Office of the National Coordinator for Health Information Technology: Washington DC. 2015. Accessed December 2015. https://www.healthit.gov/sites/default/files/briefs/oncdatabrief28_certified_vs_basic.pdf

18 Basic EHR: Physicians indicated that their reporting location used all of the following computerized functions: record patient demographics, computerized prescription order entry, viewed laboratory and imaging results, and recorded clinical notes, patient medications, allergies, and problem lists.

19 This estimate is obtained from the American Hospital Association (AHA) Annual Survey Information Technology Supplement and is based on "yes" responses to the question: "Do you possess an EHR system that has been certified as meeting federal requirements for the hospital objectives of Meaningful Use?"

20 Charles D, Gabriel M, Searcy T. Adoption of Electronic Health Record Systems among U.S. Non-Federal Acute Care Hospitals: 2008-2014. ONC Data Brief, No.23. Office of the National Coordinator for Health Information Technology: Washington DC. 2015. Accessed December 2015. https://www.healthit.gov/sites/default/files/data-brief/2014HospitalAdoptionDataBrief.pdf

21 This estimate is obtained from responses to the AHA Annual Survey Information Technology Supplement and is based on the definition: a Basic EHR has all of the following functionalities: patient history and demographics, patient problem lists, clinician notes, comprehensive list of patients' medications and allergies, computerized orders for prescriptions, and ability to view laboratory and imaging results electronically.

22 Blumenthal D, DesRoches CM, Donelan K, Ferris TG, Jha AK, Kaushal R, et al. Health Information Technology in the United States: The Information Base for Progress. Princeton, NJ. Robert Wood Johnson Foundation. 2006.

23 Office of the National Coordinator for Health Information Technology. 'Trends in Individuals Use of Health IT: 2012 - 2014,' Health IT Quick-Stat #46. 2015. Accessed December 2015. http://dashboard.healthit.gov/quickstats/pages/FIG-Individuals-Health-IT-Use.php

24 Charles D, Gabriel M, Henry J. Electronic Capabilities for Patients among U.S. Non-Federal Acute Care Hospitals: 2008-2014. ONC Data Brief, No. 29. Office of the National Coordinator for Health Information Technology: Washington DC. 2015. Accessed December 2015. https://www.healthit.gov/sites/default/files/briefs/oncdatabrief29_patientengagement.pdf

25 Heisey-Grove D, Patel V, Searcy, T. Physician electronic exchange of patient health information, 2014. ONC Data Brief, No. 31. Office of the National Coordinator for Health Information Technology: Washington DC. 2015. Accessed December 2015. https://www.healthit.gov/sites/default/files/briefs/oncdatabrief31_physician_e_exchange.pdf

26 Swain M, Charles D, Patel V, Searcy T. Health Information Exchange among U.S. Non-federal Acute Care Hospitals: 2008-2014. ONC Data Brief, No.24. Office of the National Coordinator for Health Information Technology: Washington DC. 2015. Accessed December 2015. https://www.healthit.gov/sites/default/files/data-brief/ONC_DataBrief24_HIE_Final.pdf

27 Kriplani S, Jackson AT, Schnipper JL, Coleman EA. Promoting Effective Transitions of Care at Hospital Discharge: A Review of Key Issues for Hospitalists. J Hosp Med.2007;2(5):314-23.

28 Number, rate, and average length of stay for discharges from short-stay hospitals, by age, region, and sex: United States, 2010. National Hospital Discharge Survey. http://www.cdc.gov/nchs/fastats/hospital.htm

29 Burwell SM. Setting value-based payment goals--HHS efforts to improve U.S. health care. N Engl J Med. 2015;5;372(10):897-9.

30 Samoff E, Fangman MT, Fleischauer AT, Waller AE, Macdonald PD. Improvements in timeliness resulting from implementation of electronic laboratory reporting and an electronic disease surveillance system. Public Health Rep. 2013;128(5): 393-8.

31 Overhage JM, Grannis S, McDonald CJ. A comparison of the completeness and timeliness of automated electronic laboratory reporting and spontaneous reporting of notifiable conditions. Am J Public Health, 2008;98(2):344-50.

32 Centers for Medicare & Medicaid Services. Medicare and Medicaid Programs; Electronic Health Record Incentive Program; Final rule. 42 CFR parts 412, 413, 422, and 495. 2010. https://www.gpo.gov/fdsys/pkg/FR-2010-07-28/pdf/2010-17207.pdf

33 Centers for Medicare & Medicaid Services. Medicare and Medicaid Programs; Electronic Health Record Incentive Program - Stage 2; Final Rule. 42 CFR parts 412, 413, and 495. 2012. https://www.gpo.gov/fdsys/pkg/FR-2012-09-04/pdf/2012-21050.pdf

34 Heisey-Grove D, Chaput D, Daniel J. Hospital Reporting on Meaningful Use Public Health Measures in 2014. ONC Data Brief, No. 22. Office of the National Coordinator for Health Information Technology: Washington DC. 2015. Accessed December 2015. https://www.healthit.gov/sites/default/files/databrief22_hospitalreporting.pdf

35 Office of the National Coordinator for Health Information Technology. 'Electronic Reporting to Immunization Information Services (IIS) by Stage of Meaningful Use, 2014,' Health IT Quick-Stat #49. June 2015. http://dashboard.healthit.gov/quickstats/pages/medicare-eps-immunization-registry-reporting-stage-one-and-two.php

36 Office of the National Coordinator for Health Information Technology. 'Electronic Reporting to Immunization Information Services (IIS) among Medicare Eligible Professionals, 2011-2014,' Health IT Quick-Stat #48. July 2015. http://dashboard.healthit.gov/quickstats/pages/medicare-eps-immunization-registry-reporting-trend.php

37 ONC notes the data on EHR adoption rates for behavioral health providers as cited is part of the HHS report from 2013 and that more timely data is not available at this time.

38 Office of the Assistant Secretary for Planning and Evaluation, HHS. EHR Payment Incentives for Providers Ineligible for Payment Incentives and Other Funding Study. June 2013. Accessed December 2015. http://aspe.hhs.gov/daltcp/reports/2013/ehrpi.shtml

39 The National Council for Community Behavioral Health. HIT Adoption and Readiness for Meaningful Use in Community Behavioral Health. June 2012.

40 The voluntary certification criteria for the 2015 - Data Segmentation for Privacy (DS4P) Standard - provides this privacy and security capability.

41 Office of the National Coordinator for Health Information Technology, HHS. Certification Guidance for EHR Technology Developers Serving Health Care Providers Ineligible for Medicare and Medicaid EHR Incentive Payments. 2015. Accessed December 2015. http://www.healthit.gov/sites/default/files/generalcertexchangeguidance_final_9-9-13.pdf

42 Centers for Medicare & Medicaid Services. SMD #15-003: New Services Delivery Opportunities for Individuals with a Substance Use Disorder. 2015.

43 Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Accessed December 2015. http://aspe.hhs.gov/daltcp/reports/2013/HIEengage.shtml

44 2012 National Study of Long-Term Care Providers: Tables on Use of Electronic Health Records and Health Information Exchange among Adult Day Services Centers and Residential Care Communities. CDC/NCHS, National Study of Long-Term Care Providers, 2012. Accessed December 2015. http://www.cdc.gov/nchs/data/nsltcp/EHRUse_Exchange.pdf

45 The National Council for Community Behavioral Healthcare (National Council). HIT Adoption and Readiness for Meaningful Use in Community Behavioral Health Report on the 2012 National Council Survey. June 2012.

46 ONC recognizes that actions to address information blocking must balance the need for availability of electronic health information with the need to promote other important policies, including protecting the privacy and security of electronic health information and the legitimate economic interests and incentives of market participants.

47 Office of the National Coordinator for Health IT. Report to Congress on Health Information Blocking. 2015. Accessed December 2015. https://www.healthit.gov/sites/default/files/reports/info_blocking_040915.pdf

48 HHS Office of the Inspector General, Policy Reminder: Information Blocking and the Federal Anti-Kickback Statute. 2015. Accessed December 2015. http://oig.hhs.gov/compliance/alerts/guidance/policy-reminder-100615.pdf

49 Institute of Medicine. Health IT and Patient Safety: Building Safer Systems for Better Care. 2011. Accessed December 2015. https://iom.nationalacademies.org/Reports/2011/Health-IT-and-Patient-Safety-Building-Safer-Systems-for-Better-Care.aspx

50 Health IT Policy Committee; Privacy Security Workgroup, Health Big Data Recommendations. August 8, 2015. Accessed December 2015. https://www.healthit.gov/facas/sites/faca/files/HITPC_Draft_PSWG_Big_Data_Transmittal_2015-08-11.pdf

51 Hsiao C-J, Hing E. Use and characteristics of electronic health record systems among office-based physician practices: United States, 2001-2013. NCHS data brief, No 143. Hyattsville, MD: National Center for Health Statistics. 2014. Accessed December 2015. http://www.cdc.gov/nchs/data/databriefs/db143.htm

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