Notes from the Chairs

EHRVA has been forging ahead this year with our characteristic strength and commitment to making a difference in the health IT industry. Our engagement with the strategic development of certification frameworks, interoperability efforts and marketplace education continues to build momentum. As these areas gain depth and maturity, EHRVA’s activities are positioning the Association well for ongoing contributions. We are focusing on expanding our initiatives to include critical healthcare measures related to quality, security and privacy.

EHRVA’s strong momentum was evident at the HIMSS Annual Conference in New Orleans, LA, in February where we held substantive meetings with Robert Kolodner, MD, HHS National Coordinator for Health IT, as well as representatives from the American Medical Association, Intel, HL7, CCHIT, PhRMA and HITSP. EHRVA also demonstrated the export of clinical information at the IHE Interoperability Showcase – highlights of which will also be promoted at a health IT Technology Demonstration sponsored by the Capitol Hill Steering Committee on Telehealth and Healthcare Informatics on June 21 in Washington, DC.

The Executive Committee is advancing preparations for the National Health IT Week, May 14-18, in Washington, DC, which is dedicated to promoting health IT on the national stage.

HIMSS Support to the EHRVA: HIMSS continues to support the EHRVA, which has been evident with Pat Wise’s role as both HIMSS daily supervision as well as liaison between the CCHIT and EHRVA. During recent HIMSS internal restructuring, Pat will continue to be the liaison between CCHIT and EHRVA, but we are happy to announce that Liddy West, VP of Corporate Relations will take on the daily oversight role that Pat had also been providing. We are delighted at having Liddy back with us, a former EHRVA member herself. She will be able to bring both sides of the vendor and corporate spectrum to the table, and continue to look to Pat for her connections to the CCHIT.

The Executive Committee meets weekly to further our EHRVA agenda, and we continue to rely on you to contribute to achieving our organizational goals.

Your support of EHRVA initiatives is necessary and appreciated.

Sincerely,

Don Schoen & Hugh Zettel

Don Schoen
Chairperson, EHRVA
CEO, MediNotes

Hugh Zettel
Vice Chair, EHRVA
Director, Government and Industry Relations, GE Healthcare

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Membership Committee

Chair – Justin T. Barnes, Greenway Medical Technologies
Vice Chair – Barbara Hobbs, MEDITECH

The Membership Committee manages membership criteria and materials; selection and election processes for the Board, Committees and Workgroups; new member recruitment and orientation; and annual and semiannual membership meeting planning.

Budget season is in full swing, and the Membership Committee and Workgroup Chairs are busy building our FY08 budgets to maximize the Association's EHR adoption, interoperability and advocacy efforts.

The Membership Committee is also celebrating the success of our efforts at the HIMSS Annual Conference, where we coordinated the All-Member Face-to-Face Meeting and Networking Dinner. The Committee organized additional dinners and receptions where leading EHR vendors came together to collaborate and discuss how to best advance our industry. During the conference, Committee members also reached out to EHR vendors that recently received certification from the Certification Commission for Healthcare Information Technology (CCHIT) to discuss EHRVA’s mission, initiatives and membership benefits.

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Acceleration / Adoption

Chair – Sonja Baro, McKesson
Vice Chair – Harris Gilbert, DigiChart

The Acceleration / Adoption Workgroup defines strategies and executes tactical plans with a goal of reducingacknowledged barriers to health IT adoption. The Workgroup focuses on outreach to key stakeholders including government organizations / associations, payers; provider groups / associations; other trade associations; medical associations / societies; and other groups. The Workgroup is responsible for the rollout and multi-stakeholder collaboration of the EHRVA Interoperability Roadmap.

2007 is off to a tremendous start for the Acceleration / Adoption Workgroup!

We are collaborating with the Pharmaceutical Research and Manufacturers of America (PhRMA) to identify areas where EHR use can be enhanced to support clinical information collection. PhRMA and EHRVA teams are working together to develop an education packet for EHRVA members that will help determine future collaboration.

During the IHE Interoperability Showcase at the HIMSS Annual Conference, our efforts with PhRMA were reinforced by the successful demonstration of exporting clinical information from EHR systems in support of pharmaceutical clinical research. EHRVA also presented an overview of the Interoperability Roadmap at the Showcase, highlighting an incremental, value-based approach to achieving interoperability.

In the near term, we are focusing on preparations for National Health IT Week (May 14-18) in Washington, DC. National Health IT Week is a collaborative forum where organizations with diverse perspectives on healthcare unite to send a powerful message on the importance of fostering widespread health IT adoption.

An additional opportunity is available for us to further our reach and educate those unfamiliar with our interoperability leadership. On June 6, 2007, we will meet with stakeholders to complete a pulse check regarding our Interoperability Roadmap and demonstrate the basic interoperability capabilities that were shown at the HIMSS conference. We will also demonstrate how the Roadmap links to the Healthcare Information Technology Standards Panel (HITSP) specifications and discuss our efforts to accelerate the deployment of the ASTM/HL7 Continuity of Care Document (CCD) in the marketplace.

We hope you will join us during National Health IT Week, as we work toward our goal of improving healthcare efficiency, quality, cost-effectiveness and patient safety through health IT adoption.

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Communications

Chair – Paul Edge, Misys Healthcare Systems
Vice Chair – Judy Friedman, iMedica
Consultant – Julia Zarb, Zarb Consulting

The Communications Workgroup positions the Association, its members and its initiatives as leading the health IT industry during these fast-paced and critical times in the development and adoption of EHR.

The HIMSS Annual Conference held in February provided the opportunity for both EHRVA and its member companies to promote the Association’s initiatives and accomplishments.

• The EHRVA booth was staffed by volunteer representatives. Plans for next year’s HIMSS Annual Conference include expanding this presence.
• EHRVA members proudly displayed badges and booth signage promoting the Association.
• EHRVA articles were featured in the HIMSS Dailies that were distributed to the 25K attendees of the event. The EHRVA logo was prominent on HIMSS signage.
• Media communications throughout the event positioned EHRVA for its thought leadership in the industry.

Following the conference, a survey of EHRVA’s membership was initiated to gather feedback on the Association’s presence at HIMSS and to determine how we can best serve our members at future events. If you have not had an opportunity to complete the survey, please visit http://surveys.himss.org/himss/Surveys/TakeSurvey.aspx?surveyid=1196. The survey will be open until Friday, May 18. Survey results will be posted on the EHRVA intranet site for members to view.

In addition to ongoing support for CCHIT and advocacy efforts, the Communications Workgroup is launching an EHRVA Member Toolkit that will coincide with National Health IT Week. This kit will provide materials for members that relay the impact of their involvement in EHRVA activities.

• One of the Toolkit components developed by the Communications Workgroup is the newly available article, “HIMSS EHRVA Ensures the Vendor Voice is Heard by CCHIT.” This educational piece highlights EHRVA’s involvement with and impact on the CCHIT certification program. The article is available online.

The Communications Workgroup will also promote Hugh Zettel as a National Health IT Week spokesperson and draw focus on EHRVA activities in DC during this time. Visit www.HealthITWeek.org for ongoing updates and details.

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Government Initiatives & Organizations

Chair - Charlie Jarvis, NextGen Healthcare Information Systems
Vice Chair - Rick Reeves, Computer Programs and Systems

The Government Initiatives & Organizations Workgroup sets strategy for interaction and participation with established government and private sector initiatives related to EHR.  This group will continue to drive CCHIT relations and responses.

The Government Initiatives & Organizations Workgroup would like to thank the companies that participated in five site visits during the HIMSS Annual Conference in New Orleans. The primary purpose of these visits was to make the government aware of what still needs to be done in New Orleans post-Katrina. The clinics that were visited include Heart and Vascular of Louisiana, Clinical Consultants of Louisiana, and Tourno Clinic; customers of NextGen, Siemens, McKesson, MediNotes and MEDITECH. Approximately 25 government officials participated in these visits, including legislative officials and aids, regulatory officials from ONC, CDC personnel, and state aids.

As a result of one of the site visits, a nurse practitioner who cares for more than 400 home-bound patients was invited to speak at the HIMSS Advocacy and Public Policy Breakfast. Government officials are currently working to secure funding for her practice to get an EHR system.

We’re excited to be involved again this year with National Health IT Week, where we will host an interoperability demonstration, which includes security and privacy, as well as stakeholder discussions. Hugh Zettel, EHRVA Vice Chair, is a national spokesperson for National Health IT Week and will bring prominence to EHRVA as he comments on the transformative value of health IT to a broad media spectrum.

The Workgroup will also present at the HIMSS Government Relations Roundtable meeting on Monday, May 7, at 12:00 pm ET at the EDS Building in Washington, DC.

We are pleased to announce that Justin Barnes, Chair-EHRVA Membership Committee, has been appointed to the State Alliance for e-Health Task Force.  The State Alliance for e-Health was developed by the National Governor’s Association and addresses state-level health information technology issues and challenges to enabling appropriate, interoperable, electronic health information exchange (HIE).

We would like to encourage all members of the EHRVA to get involved with our initiatives – participation enables you to serve as the voice of the Association in legislative and organizational outreach. Please contact Charlie Jarvis at cjarvis@nextgen.com if you would like to join.

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Standards & Interoperability

Chair – Charles Parisot, GE Healthcare
Vice Chair – Davin Hills, MediNotes

The Standards & Interoperability Workgroup evaluates all standards and third-party standards setting organizations and establishes a strategy for interacting with each.  Initial interoperability projects have focused on HL7, CCR, RHIO, IHE, lab terminology and security standards.

We want to thank the numerous EHRVA member companies that participated in the IHE Interoperability Showcase at the HIMSS Annual Conference, making it a huge success! This year’s Showcase featured several new elements:

• Secured health information exchange with broad content
• New Directions focus:
• Life sciences (bio-pharma)
• Patient Identifier Cross-Reference (PIX) and Patient Demographic Query (PDQ) HL7 v3.0 transactions
• EHR Lab Interoperability and Connectivity Standards (ELINCS) specification
• HITSP Interoperability Specifications
• Clinical data exchange among patient care devices
• Personal health record solutions
• Financial and administrative systems for billing and claims attachments (CAQH CORE)
• Clinical scenarios focusing on clinician and patient access and information-sharing across the full continuum of care

In all aspects of the Showcase, EHRVA members showed how they are collaborating to provide widely accepted interoperability solutions in the enterprise and across care settings.

We convened in Chicago for the Standard & Interoperability Workgroup’s annual face-to-face meeting April 9-11, where we assessed the current interoperability landscape, identified major objectives and set strategy for the next 12 months. Following our meeting, IHE launched its Quality Domain at a two-day meeting April 11-12. We thank all EHRVA members who participated in these meetings!

On March 19, the HITSP Consumer Empowerment Interoperability Specification was released for final review. The document defines specific implementations of established standards intended to achieve integration goals that promote appropriate exchange of a consumer’s PHR information.

• This specification identifies a subset of the functional components of the healthcare enterprises and health information networks called HITSP actors and specifies their interactions in terms of a set of coordinated, standards-based transactions.

HITSP also released the Registration and Medication History Document Content Component for final review. This component is part of the series needed to conform to the HITSP Consumer Empowerment Interoperability Specification. It describes the document content that summarizes a consumer’s registration and medication data information contained within a PHR for the purpose of information exchange.

• While a PHR can contain much more information, this component only deals with the exchange of summary information to and from the PHR. The registration summary is restricted to the information consumers generally need to provide when visiting a physician, hospital or pharmacy, including:
• Demographic information
• Financial information
• Basic clinical information

This component allows consumers to establish and manage permissions access, rights and informed consent for authorized and secure exchange, viewing and querying of their linked patient registration summaries and medication histories between designated caregivers and other health professionals.

The medications, allergies and drug sensitivities, and conditions structured and coded terminologies included in the HITSP Consumer Empowerment Interoperability Specification will open a critical review of HITSP deliverables that CCHIT will have to adopt as such. Unlike functionality criteria, interoperability criteria cannot be segmented. This will have a major impact on EHR-to-PHR communications and even more of an effect on the EHR-to-EHR side.

Our Workgroup submitted comments to HITSP by the April 6 deadline.

Additionally, our Workgroup is working with the American Clinical Laboratory Association (ACLA) to identify collaborative opportunities between our associations. ACLA is the leading advocate for the clinical laboratory industry, providing effective communication with Congress, regulatory bodies, healthcare organizations and the public. EHRVA and ACLA plan to partner on issues that affect both our memberships, including issues relating to federal and state government reimbursement, payment for laboratory services and regulatory policies.

We strongly encourage you to join our workgroup! This is a unique opportunity to learn more on ASTM/HL7 CCD, the terminologies that have been selected for a core patient charts interchange, as well as the underlying document sharing and patient ID cross-referencing infrastructure.

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Quality Initiatives

Charlene Underwood, Siemens

The Quality Initiatives Workgroup was recently formed in response to the evolving focus on quality initiatives in health IT.  The EHRVA voice is gaining recognition in the quality arena and continues to be invited to the table in critical dialogues of national importance.

Value-Driven Healthcare
The value-driven healthcare initiative, a plan implemented as a result of President Bush’s 2006 executive order, provides public information about the quality and cost of services delivered by healthcare providers, enabling consumer choice and value-based competition.

In support of the value-driven healthcare initiative, Health and Human Services (HHS) Secretary Michael Leavitt chartered an American Health Information Community (AHIC) Quality Workgroup to define a harmonized “starter set” of quality measures that can be captured as a byproduct of using IT workflow. Charlene Underwood, Director, Government and Industry Affairs, of Siemens Medical Solutions, represents the EHRVA in this Workgroup.

The Quality Workgroup has discussed the following topics:

• What the American Quality Alliance/Hospital Quality Alliance measures are
• How to ensure providers are able to use electronic means to report them
• How to ensure future measurement specifications are built into electronic capture and reporting tools

EHRVA outreach on quality is leading to collaboration with several key stakeholders in the national dialogue. Recognizing the challenges in meeting the goals of the value-driven healthcare system, leadership from the American Medical Association (AMA), the Center for Medicare and Medicaid Services (CMS) and the National Committee for Quality Assurance (NCQA) met with EHRVA and established the Collaborative for Performance Measure Integration into EHR Systems. Primarily focused on ambulatory records but working toward developing an infrastructure for use in all care settings, the Collaborative is charged with defining a standard methodology for integrating clinical and technical specifications in order to incorporate performance measures into EHR applications as well as a standardized way to report performance measures.

Use Case Development
The Office of the National Coordinator for Health Information Technology (ONC) commissioned a quality use case that will require standard selection and harmonization efforts by the HITSP Population Health Technical Committee. EHRVA is currently involved in work being done by Floyd Eisenberg, MD, MPH, Siemens Medical Solutions, co-chair of the HITSP Population Health Technical Committee.

The IHE Quality Domain was launched at a two-day meeting April 11-12 in Chicago. This new domain will address the infrastructure necessary to share information relevant to quality improvement in electronic patient care and health care records. Members of EHRVA attended to provide input on the development of use cases that will form the basis of a Technical Framework to guide implementation of the capability to share quality guidelines in EHR applications and related systems.

Pay-for-Performance
CMS pay-for-performance programs provide financial incentives for customers to report quality measures. EHRVA advocates a uniform set of measures that can be enabled by EHRs in these programs.

Physician Quality Reporting Initiative (PQRI)
PQRI establishes a financial incentive for eligible professionals to participate in a voluntary quality reporting program. Eligible professionals who successfully report a designated set of quality measures as part of claims attachments for dates of service from July 1 to December 31, 2007, may earn a bonus payment, which is subject to a cap of 1.5% of total allowed charges for covered Medicare physician fee schedule services (Title I, Section 101, of the Tax Relief and Health Care Act of 2006).

Medicare Care Management Performance Demonstration
The Medicare Care Management Performance Demonstration, authorized under Section 649 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, is a three-year pay-for-performance pilot with physicians to promote the adoption and use of health IT to improve the quality of patient care for chronically ill Medicare patients.

Under the demonstration, practices are financially rewarded for reporting clinical quality data and meeting clinical performance standards for treating diabetes, congestive heart failure and coronary artery disease as well as providing preventive services such as immunizations and cancer screenings to high-risk, chronically ill Medicare beneficiaries. Practices that have a CCHIT-certified EHR and are able to report the clinical quality measure data electronically will be eligible to receive additional incentive payments.

CMS is currently recruiting practices in Arkansas, California, Massachusetts and Utah to participate in the demonstration. Small and medium-sized primary care practices participating in the Doctor’s Office Quality Information Technology (DOQ-IT) program are eligible to apply. Applications are due by April 15, and the demonstration will begin July 1, 2007.

More information about the demonstration, eligibility requirements and the clinical quality measures data that will be collected can be found online.

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Calendar of Events

HL7 - May Working Group Meeting
May 2 – 4
Cologne, Germany

HITSP Meeting
Friday, May 11
10:00 am – 5:00 pm ET
Washington, DC

National Health IT Week
Monday, May 14 - Friday, May 18
Washington, DC

HIMSS Advocacy Day
Tuesday, May 15
8:00 am – 5:00 pm ET
Washington Court Hotel
Washington, DC

Capitol Hill Steering Committee on Telehealth and Healthcare Informatics Seminar Series: “Collaborative Public-Private Sector Efforts: Leveraging Government Resources Toward Technology Transfer and Diffusion”
Wednesday, May 16
Washington, DC

HIMSS Virtual Conference & Expo
Wednesday, May 16 – Thursday, May 17

IHE Quality Planning and Technical Committee Face to Face Meeting
Monday, May 21 – Thursday, May 24
Hilton Garden Inn
Des Plaines, IL

AHIC Meeting
Tuesday, June 5
8:30 am ET
Hubert H. Humphrey Building
Washington, DC

IHE Educational Workshop
Monday, June 11 – Wednesday, June 13
Oak Brook, IL

Capitol Hill Steering Committee on Telehealth and Healthcare Informatics Seminar Series: “Current Status of Public and Private Sector Legal and Regulatory Issues for HIT; Standards, Licensure and Accreditation, FDA Approvals, Broad-Band Access, and More”
Wednesday, June 20
Washington, DC

Capitol Hill Steering Committee on Telehealth and Healthcare Informatics Seminar Series: “Health Information Technology All-Day Technology Demonstration, Showcase and e-Health Panel Discussion”
Thursday, June 21
Washington, DC

IHE PCC & ITI Technical
Monday, July 23 - Thursday, July 27
Oak Brook, IL

HITSP Meeting
Monday, July 16
10:00 am – 5:00 pm ET
Washington DC

AHIC Meeting
Tuesday, July 31
8:30 am ET
Hubert H. Humphrey Building
Washington, DC

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