New Competition Initiative for Health IT

The Office of the National Coordinator last month announced a new initiative to spur health IT innovations through a series of prizes, challenges and other mechanisms to improve the nation’s health care system. The Investing in Innovations (i2) Initiative will leverage prize authority in the America COMPETES Reauthorization Act, which is designed to spur innovation through prize money and nationwide challenges. This will be the first Obama Administration initiative utilizing funds from the COMPETES Act.

Specific details are still being developed, but examples of health IT competition topics for the future include: applications that allow individuals to share health information with their social network; applications that provide patients and physicians access to information that can result in immediate decisions; and tools that facilitate exchange of customized health information allowing for individualized privacy settings.

In other health IT news…

President Highlights Community College Consortia
President Obama announced last month new efforts to expand the Skills for America’s Future Initiative, an industry-led initiative to dramatically improve industry partnerships with community colleges to prepare 500,000 workers for new jobs. The Initiative complements the Office of the National Coordinator’s “Community College Consortia,” which is a program designed to educate health IT professionals. The President highlighted the Consortia during his recent announcement.

The Community College Consortia program is made up of 82 community colleges representing all 50 states. Member colleges are receiving funding to rapidly create health IT academic programs or expand existing health IT training programs. In all, the colleges hope to train more than 10,500 new highly skilled health IT specialists by 2012.

Physician Practices Not Fully Utilizing EHRs, Study Finds
A recent Health Affairs study reports that few small and mid-sized physician practices are fully utilizing electronic health record systems. The national study found that a quarter of small and mid-sized physician offices are using EHRs for progress notes, but a much smaller amount are using EHR for essential components of the patient-centered medical home. The critical components include electronic prescribing, online messaging with patients, and care coordination. Smaller practices were utilizing EHRs at an even smaller rate than mid-sized practices.

The reasons for underutilization of EHRs among small to mid-sized practices vary. Ultimately, smaller practices have limited resources, including time and money; however, larger practices to do not typically face this challenge. Additionally, the nature of the patient population that smaller practices serve has an impact as well. Rural populations are less likely to be online and engaging in electronic communications with doctors.

The study recommends more leadership and technical assistance for small physician groups in order to surmount the obstacles to full EHR implementation. The implementation of Regional Extension Centers (RECs) is one example of practices to assist smaller practices, although, to date, only 31,000 of the 81,000 physicians who have signed up for the REC program are small practices.

Meaningful Use Stage 2 Requirements Likely Delayed Until 2014
The second stage of meaningful use measures for EHRs will likely be delayed for one year, until 2014, after the Director of the Office of the National Coordinator for Health IT (ONC) Dr. Farzad Moshashari endorsed the move this month. The delay will help avoid a potential future timing problem, with publication of the final rule for stage 2 requirements currently scheduled to occur just several months before the provider reporting period would begin. At present, the original 2013 timeframe would not give IT vendors enough time to design, develop and test new functionality for providers to deploy stage 2 measures, according to a recent Government Health IT news report.

The one-year postponement was originally recommended by the Health IT Policy Committee in June by a 12-5 vote. Dr. Mostashari later backed the recommendation, which signals that the federal government will follow the proposal from the committee. Mostashari said that widespread deployment of the next set of EHR systems in less than six months would be infeasible and could have a detrimental effect on physicians attempting to meet the “meaningful use” requirements for stage 2.

The ONC and the Centers for Medicare and Medicaid Services are expected to release their proposed rules, standards and certification criteria on meaningful use of EHRs by the end of 2011 or early 2012. Once public comments are accepted, the rules should be finalized by next summer.