Despite spending more on health care than other countries, an international survey from the Commonwealth Fund finds the United States lags behind on important measures of access, quality and use of health information technology (HIT). There are opportunities to learn as other countries move ahead to enhance the primary care foundations of their health care systems.

The authors surveyed more than 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom and the United States. Data were collected by mail, by telephone and over the Internet between February and July 2009.

Research shows that strong primary care is associated with good health outcomes and lower costs. It also can help meet the challenges presented by aging populations and the rising incidence of chronic disease. Across the globe, countries are working to redesign their primary care systems by investing in information technology, round-the-clock access, teamwork, integration and quality improvement. They also are working to reform delivery systems and payment policies. This study surveyed primary care physicians in 11 countries to find out what is happening on the front lines of health care.

Only 46 percent of U.S. doctors use electronic medical records, compared with more than 90 percent of doctors in Australia, Italy, the Netherlands, New Zealand, Norway, Sweden, and the United Kingdom.

The advanced health information technology and extensive use of quality incentives and care teams reported by Australian, Dutch and New Zealand doctors reflect national payment and information system policies focused on primary care. Lacking such policies, the U.S. lags far behind its peers in these areas--even as it spends far more on health care overall. In addition, insurance coverage restrictions make it difficult for many U.S. physicians to provide their patients with timely access to care.

The first public comment period for the Certification Commission's 2011 development cycle is open through Dec. 11, 2009. Comments will be accepted on the first draft of criteria for Behavioral Health electronic health records (EHRs)--both standalone and as an optional add-on to Comprehensive Ambulatory EHR certification--as well as add-on certifications for Clinical Research and Dermatology. After additional rounds of comment and refinement, these new certification options will be made available to vendors in July 2010.

Comments will only be taken through the Commission's Web site at http://www.cchit.org/participate/public-comment.

"Dedicated volunteers in these specialty care areas have done a remarkable job drafting criteria that will provide more options for our 2011 Comprehensive certification program," said Mark Leavitt, MD, PhD, chair of the commission. "Our goal is to recognize the diversity of medical practices and specializations that make up health care, and tailor certification programs accordingly."

Dr. Leavitt also noted, "We have received over 20 applications for our 2011 certification programs, with both the CCHIT Comprehensive and the Preliminary ARRA pathways represented. We will be announcing the first products certified soon."

The Commission also plans to open public comment from Dec. 14, 2009, through Jan. 12, 2010, on the first round of criteria for Long Term and Post Acute Care (LTPAC) EHRs. The first priority for this new domain is development of a core set of criteria for the collection of care settings encompassed in LTPAC and specific criteria for the first two settings--skilled nursing facilities and home health agencies--identified as priorities by the Commission's LTPAC Advisory Task Force. These certification programs are also scheduled for a July 2010 launch.

The Certification Commission for Health Information Technology (CCHIT) announced that Mark Leavitt, MD, PhD, is planning to retire from his role as Chair of the Commission on March 31, 2010. The Board of Trustees has initiated a national search for a successor.

 "Mark's vision and leadership has been nothing short of remarkable. He has unquestionably been the right leader at the right time, maturing an industry and setting up an adaptive and strong entity ready for the next round of challenges," said Linda Kloss, RHIA, CAE, FAHIMA, CCHIT trustee.

 "Having the privilege to launch and lead this volunteer-based, nonprofit organization has been one of the most rewarding and educational experiences of my life," said Dr. Leavitt. "Now it is time for me to keep a promise I made to myself and my family when I first took on this role 5 years ago, knowing that I will leave it in the hands of an exceptional group of volunteers and a highly capable and knowledgeable staff." 

"The Board accepts Mark's decision with reluctance but appreciates his commitment to overseeing a seamless transition," said H. Stephen Lieber, chair of the Board of Trustees. "The search for his successor will be open and transparent so we maintain the confidence of our many constituents. CCHIT trustee Frank Trembulak, executive vice president and chief operating officer of Geisinger Health System, will chair the search committee, and a firm has been retained to conduct the search. More information with duties and qualifications will be available on CCHIT's web site soon."

Memorial Hospital at Gulfport, MS, has selected Allscripts electronic health record (EHR) and practice management (PM) solution, with its revenue cycle management, to enhance the quality of the care delivered by its 100 employed physicians, improve patient communications and better manage the cost of care delivery. 

Memorial Hospital at Gulfport, located 70 miles east of New Orleans, is one of the largest health care providers on the Mississippi Gulf Coast. Among the most comprehensive medical facilities in Mississippi, Memorial is a not-for-profit 445-bed facility with 30-owned physician clinics, a medical staff of 275 physicians and a long history of investing in technology. Memorial is rated a Stage 5 hospital on the HIMSS Adoption scale, placing it in the top 5 percent of U.S. hospitals for the use of information technologies to maximize patient safety. 

The Allscripts EHR enables Memorial's physicians to instantly access patient information when and where they need it--in the clinic, at the hospital or while on-call at home--and automates everyday clinical tasks such as prescribing medications, documenting patient visits and obtaining best-practice guidelines for care.

The hospital is excited at the prospect of connecting the EHR with the Mississippi Coast Health Information Exchange (MSCHIE), a state program focused on enhancing health care infrastructure in Gulf Coast counties devastated by Hurricane Katrina in August 2005. Memorial is a founding member of the HIE, which will enable the hospital's physicians to share and access secure, aggregated patient clinical information from IT systems in physician offices, hospitals and other care sites 24 hours a day.

Drummond Group Inc. announced that it will submit to become a certifying body upon the release of the Office of the National Coordinator for Health Information Technology (ONC) requirements for certifying bodies for Electronic Health Records (EHRs). Drummond Group has been approached recently by numerous EHR software and services companies that need to be certified.

"Clearly there is a growing demand for EHR certifications," said Rik Drummond, CEO of Drummond Group. "Drummond Group has been supporting Fortune 500 industries and government by certifying the transfer, identity and cyber security of their Internet information flow over the last 10 years. We have also done testing for the CDC, DEA and GSA. Certification of EHR is a natural extension of our testing program, and we believe we can provide great value for the medical community. We look forward to the publishing of the ONC requirements in the days ahead so we can get started."

ONC is currently working on the scope and definition of "meaningful use" for EHR, expected to be finalized in early 2010. Along with these new policies on meaningful use of EHRs, the ONC has announced plans to expand the number of EHR certification agencies to support the new initiative. Currently, the only approved EHR certification agency is the private non-profit CCHIT organization.

The TriZetto Group Inc. announced additional features and functions of its new personal health record (PHR), which at year's end the health care IT firm will make available free of charge to health insurers that use its Facets enterprise administration software and in early 2010 to payers using its QNXTTM application. The PHR will be free, as well, to the providers and consumers who use the electronic record.

When health plans deploy TriZetto's PHR, consumers will have immediate access to their pre-populated record and may designate family members who can access their record. When physician staffs request eligibility confirmation, payers will be able to provide a concise summary of relevant facts from the patient's PHR.

"Unlike hospital electronic medical records and physician office electronic health records, TriZetto's PHR will include information from all of the doctors and facilities that treat a patient over time," said Dave Pinkert, senior vice president of product management at TriZetto. "Further, only our PHR, populated by the rich repository of digital benefits and care information already in the systems of health care payers, are ready now for deployment to nearly half of the nation's insured."

Fully supporting industry interoperability and security standards, TriZetto's PHR will enable a patient to give a provider a fully digital record of his or her health history. The record will include the following information from the health care payer's claims system:

• Procedural history, including
• Lab work
• Exams
• Surgeries and other treatments
• Diagnoses
• Healthcare providers who have treated the patient

Members will be able to access their PHR online, with the ability to add or supplement information about:

• Family history (e.g., diseases and medical conditions of parents, siblings)
• Emergency contacts
• Medications and dosages
• Allergies
• Claims
• Immunizations
• Personal details, such as preferences and behaviors that can affect health status.

Trust Catalyst, a research firm helping companies build data protection strategies that strengthen customers' trust, announced the findings of its second annual 2009 Encryption and Key Management Benchmark Report, which surveyed more than 600 IT security professionals and was sponsored by Thales.

The study found 41 percent surveyed encrypt backup tapes, 43 percent encrypt databases and 49 percent encrypt full disks, despite the growing number of new industry, state and national data protection regulations. While participants indicated the protection of health care and credit card data was driving future IT spending, 19 percent said they would wait for a data breach before they would encrypt tapes. This data left unprotected in databases and backup tapes causes these organizations to be at higher risk for a data breach.

The study revealed the primary obstacles preventing organizations from encrypting these applications were due to concerns about cost and data availability. Once data is encrypted, participants fear they could lose this data or it would not be available when it was needed causing a business disruption even though twice as many surveyed admitted to a data breach than losing data because of a lost encryption key.

The full 2009 Encryption and Key Management Benchmark report can be downloaded from http://www.trustcatalyst.com/2009EncryptionSurvey.php.

Doctations Inc. added its new Surveillance Program functionality to its online health care and medical practice management solution. The Surveillance Program makes it easy for physicians to comply with government-mandated HITECH ACT requirements to qualify for and receive the ARRA bonus of up to $44,000 through 2016.

The new Surveillance functionality is the latest addition to Doctations' cloud-based solution that enables physicians to manage all clinical and business aspects of their practices online, including securely managing electronic medical records and electronically transmitting prescriptions. The Doctations Surveillance Program enables doctors to meet requirements for the E-prescribing incentive program 2 percent bonus, comply with the Physicians Quality Reporting Initiative (PQRI) for another 2 percent bonus, qualify to receive up to $44,000 in incentives through 2016 from the High-Tech Bonus (ARRA funding) program, and avoid escalating non-compliance penalties all without any added administrative burden. 

Because the Doctations system is web-based, applications can be updated in real time as needed. This ensures that the network of Doctations subscribers is always current and in immediate compliance with the latest government regulations and requirements. With the Surveillance Program especially, Doctations offers a unique advantage over legacy and premises-based systems where users must wait for onsite implementation of new versions of application software.

The Doctations application is CCHIT-certified to current standards. In keeping with the company's dedication to maintaining standards and regulatory compliance, Doctations has committed to updating its application software to meet any new certification requirements that may be added going forward.

The Certification Commission for Health Information Technology (CCHIT) is seeking senior executives working in health care to serve on its Board of Trustees and Board of Commissioners.

The Commission's nine-member Board of Trustees has fiduciary responsibility and provides leadership in the areas of fiscal oversight and stewardship of assets, organizational strategy, evaluation of senior management, and resolution of any conflicts of interest involving the Commission's management and its 21-member Board of Commissioners. The Board of Commissioners oversees certification criteria developed by voluntary work groups, provides strategic direction and ensures the objectivity and credibility of the Commission.

Members of the Board of Trustees set direction and provide oversight of the policies, affairs and funds of the organization in accordance with the bylaws and articles of incorporation of the CCHIT, a nonprofit 501(c)3 corporation. Application requirements include senior leadership experience (vice-president or above), previous experience as a director or trustee on nonprofit boards of directors, and a demonstrated understanding of the mission and vision of the Commission. Trustees are nominated by the current board and serve 3-year terms rotating each January; trustees may be reappointed for a second term. A third of the Trustees have terms that are expiring this year. 

Members of the Board of Commissioners are senior executives representing a wide range of stakeholders across the private and public sectors of healthcare and health IT. Those include physician practices and hospitals, payers, health care consumers, vendors, safety net providers, public health agencies, quality improvement organizations, clinical researchers, standards development and informatics experts and government agencies. Commissioners serve staggered two-year terms and may be reappointed for a second term. This year, about a fourth of the Commission positions are expected to be open. Applicants from physician practices, safety net providers, hospitals, and consumer representative organizations are especially sought. No vendor positions are open during this recruitment.

The application period for both boards will be open until Nov. 20, 2009, for terms that begin in January 2010. Candidates interested in applying for either the Board of Trustees or the Board of Commissioners should apply at http://cchit.org. New appointments will be announced in December.

CCHIT also announced that its first 30-day public comment period of the 2011 development cycle will open Nov. 16 - Dec. 15, 2009. Comment will be accepted for the first round of criteria for additional electronic health record (EHR) Comprehensive certifications not included in the Commission's Oct. 7 launch of CCHIT Certified Comprehensive and Preliminary ARRA certification programs. These expanded areas include Clinical Research and Dermatology criteria (optional add-ons to the current Ambulatory EHR certification) and Behavioral Health EHR criteria -- both standalone and as an optional add-on to the current Ambulatory EHR certification. Comment will only be taken through the Commission's Web site.

Wyse Technology, a company focusing on thin computing and client virtualization, announced another successful customer implementation. Metro Health Village, located near Grand Rapids, MI, is one of the most comprehensive health care providers in west Michigan. Its staff of approximately 1,000 doctors and nurses provide care to nearly 11,000 inpatients each year, handle nearly 50,000 emergency room visits, and 320,000 visits to the outpatient centers each year.  In all cases, patient records are accessed, updated and managed via thin clients from Wyse Technology.

"No one knows exactly what shape health care reform will take," according to Bill Lewkowski, Executive VP and CIO at Metro Health, "but what is clear to me is that the path to healthcare IT reform is through virtualization. From electronic medical records (EMRs) to physician collaboration to HIPAA compliance to IT costs, there are too many benefits to virtualization to ignore."

Metro Health Village is a groundbreaking concept and the first of its kind in the nation. The 170-acre state-of-the-art campus is far more than home to the first suburban hospital in the region. It's an entire community of support services, retail, restaurants and more with the new Metro Health Hospital as its central focal point.

When Metro Health Hospital was constructed, Lewkowski's mandate was to ensure that patient information was immediately accessible to authorized personnel across this new campus, and even more widely through the Internet.

"Health care is all about information," Lewkowski added. "That information has to move in real-time among team members coordinating care for a patient. It also has to move rapidly to the patient's location--from surgery suites to patient rooms to the front desk to the pharmacy, faster than a patient can be wheeled from one location to another.  Virtual desktops from Wyse provide us with this capability and more."

Metro Health currently has Wyse thin clients deployed throughout Metro Health Village. Approximately 4,000 employee sessions are always running in Metro Health's data centers. Employees--clinicians, pharmacists, receptionists--simply go up to any of the approximately 1,250 Wyse V90 Windows XP Embedded thin client workstations in the hospital, enter their login information, and immediately see the same screen they had up when they logged out of their last session. It takes fewer than 15 seconds for a doctor to access a patient's information rather than the several minutes it would take to log in to a PC, open up the applications, and call up the data.

Wyse Device Manager is used to securely manage the thin clients deployed throughout Metro Health Village organization for asset management, configuration management, diagnostics, and firmware updates for thin clients and supported smart devices. Wyse TCX is also in place at Metro Health to assure that the end user experience with audio, video and multimedia files is as good as or better than a PC experience.

Metro Health users work with hundreds of applications, but the most critical applications include EPIC EMR and clinical systems, iSite digital radiology, and various McKesson applications that address patient management, billing and other administrative needs.