Top Impacts of Problem Lists on Interoperability and Meaningful Use
Posted by AMS at 21 MAY 10:36 am
During last week’s webcast, held by the Health Resources and Services Administration, presenters from the Office of the National Coordinator for Health Information Technology (ONC) and Blackstone Valley Community Health Care in Pawtucket, RI provided an overview of the aim of problems lists in the EHR Incentive Programs as well as the challenges involved in satisfying this requirement in current and future stages of meaningful use.
As noted by one of the presenters, structured problem lists will be key to enabling EHR interoperability moving forward with meaningful use. “As we all realize, interoperability will play a major role going forward in Meaningful Use Stage 2 and beyond, and we can be expected to interoperable with other healthcare providers and the different HIT systems used at various practice sites,” said Raymond J. Lavoie.
And why is this? As it turns out, most of the data needed to be exchanged from eligible provider to eligible provider traces its origins back to the problem list.
“One of the foundations of this capability will be the common dataset prescribed for all summary of care records by the final rules for Stage 2,” explained Lavoie. “Each element of the summary of care record will include a structured and coded dataset uniformly formatted and capable of being securely transmitted for transitions of care, for referrals, discharge, and also shared directly with the patient. In short, it will be a common language that is understandable by all certified EHR technology systems. Any of the elements in the summary of care record are derived from or are uniquely related to the problem list.”
Beginning in Stage 1 Meaningful Use, eligible hospitals are required to maintain up-to-date problem lists for current and active diagnoses. Specifically, the measure calls for providers to have “at least one entry or an indication that no problems are known for that patient recorded as structured data” for more than 80 percent of unique patients seen.
Stage 2 Meaningful Use approaches problem lists differently by featuring problem lists in requirements for summaries of care and view, download, and transmit (VDT) instead of in its own objective. For eligible professionals, hospitals, and critical access hospitals in Stage 2, they must provide summaries of care, which include current, active, and historical diagnoses, for patients transitioned or referred to another provider. Additionally, patients must have the ability within four business days to VDT although the problem list is not a required element.
Although the specifics of Stage 3 Meaningful Use are still being ironed out, early indications are that problem lists will be integrated in an objective for clinical decision support (CDS) as well as other requirements for the reconciliation of problems lists, maintenance of summaries of care, and increased emphasis on VDT
Source: www.ehrintelligence.com; Kyle Murphey; May 21, 2013.
Clinicians slow to adapt to digital medicine have until June 30 to electronically transmit 10 prescriptions to the pharmacy for Medicare patients, and thereby avoid a 2% cut in their Medicare reimbursement next year.
Rep. Ted Poe (R-Texas) has introduced a bill (HR 1701) that would prohibit HHS from mandating that health care providers switch to ICD-10 code sets, ICD-10 Watch reports (Natale, ICD-10 Watch, 4/25).
Made available through the ONC’s National Rural Health Resource Center, the toolkit provides a set of “practical” HIE resources designed to help rural health stakeholders, including State Offices of Rural Health and Flex Programs, rural hospitals and clinics, 
Six Republican Senators have formally requested that U.S. Department of Health & Human Services Secretary Kathleen Sebelius provide a written plan to address how the agency is implementing the Health Information Technology for Economic and Clinical Health (HITECH) Act.
Last June, Rep. Renee Ellmers (R-N.C.) 