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Re: [Gnumed-devel] Interest in GNUmed

From: Jim Busser
Subject: Re: [Gnumed-devel] Interest in GNUmed
Date: Wed, 21 Oct 2009 17:22:23 -0700

On 2009-10-21, at 3:26 PM, Jim Busser wrote:

If the above looks attractive for simple billing can I recommend that we build on the GNUmed proposal already in place for billing, in which GNUmed could capture basic information in a billable items table and secondarily pass this information to either a simple system (Simple Invoices) and/or to a complex system such as may be able to perform (e.g. United States) e-billing:

Strategic pieces to know about for US-relevant (and maybe internationally-relevant) development:

CCHIT opens modular certification program
“We are concerned that providers could not achieve meaningful EHR use in 2011 if they wait until spring 2010 – the expected date of HHS final approval of requirements – to begin adopting this technology,”

CCHIT proceeds with limited EHR certification
"Providers must demonstrate that they are meaningful users of health IT to be eligible for Medicare and Medicaid incentive payments under the stimulus. The Centers for Medicare and Medicaid Services will publish a proposed rule in December that describes what physicians and hospitals must do to meet meaningful use requirements and to receive increased payments starting in 2011"

Healthcare providers see certainty on meaningful use
The goals for meaningful use are for providers to electronically capture data, report quality measures and use the data to track patients’ medical conditions.
"Eligible physicians can receive up to $44,000 over five years under Medicare or $63,750 over six years under Medicaid for being meaningful users of certified EHRs."

# the above may allow doctors to qualify as meaningful users of those modules GNUmed already supports pending anything more that the incentive payments could support to get built

Other pieces:

Health IT group approves standards and quality measures
"A matrix of 27 quality measures and 12 standards capabilities, which are endorsed by HITSP, a standards organization formed by the Office of National Health IT Coordinator in 2005, build on each other for improved patient outcomes...
… To report the quality measures, the work group recommended that providers have implemented the 12 HITSP endorsed standard capabilities, including being able to transmit in-hospital and out-patient prescriptions, structured health data such as those for discharge summary and continuity of care documents, and lab test results.
… Providers who have not begun to adopt electronic health records and other health IT standards may use unstructured data such as documents in PDF format in 2011, but must by then be able to meet the structured data standard to report quality measures, Halamka said.
… The committee also recommended that providers be fully compliant with the HIPAA privacy and security rule in 2011 as part of meaningful use.
… … Dr. David Blumenthal, the national health IT coordinator, must craft an interim final rule on meaningful use criteria by December. CMS will issue a rule also in December defining meaningful use for the incentive program.

IS 107 - EHR Centric Interoperability Specification

IOM: Feds should add ethnicity and language measures to EHRs

Chopra seeks outside advice on health IT standards
"For instance, providers will have to migrate from using ICD-9 to ICD-10 to SNOMED CT by 2015 to record physician’s clinical observations in an electronic health record."
# GNUmed has been built to support any number of classification / coding schemes

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