A Medical Device Daily

The term "meaningful user" sounds like government-speak gone mad, but those in the healthcare information technology (HIT) industry will have to "get used to it," as was made clear during a session at last month's World Health Care Congress (Medical Device Daily, April 20). Those who wondered how that phrase would be defined now have a starting point of sorts provided courtesy of the Health Information Management Systems Society (HIMSS; Chicago).

HIMSS published two documents last week defining the term for hospitals and non-hospital users. Among the recommendations the documents make is that the Department of Health and Human Services adopt the Certified Commission for Healthcare Information Technology (CCHIT; Chicago) "as the certifying body" for electronic health records (EHRs), which HIMSS justifies thanks to CCHIT's "demonstrated long-term commitment to an open and transparent process," among other reasons.

HIMSS set up a series of milestones for healthcare providers that the documents recommend should take no longer than two years each to achieve. The first metric, which would commence in 2011, would entail tying together all clinical data systems and linking them to patient accounting systems. HIMSS also recommends for this two years that clinical observations be computerized and available to all users throughout the provider entity.

For phase II, which would commence in 2013, HIMSS suggests that "at least 51% of all medical orders are electronically entered" and that all provider prescribing be linked to pharmacies outside the hospital. As for phase III (2015 as a start date), HIMSS suggests that hospital providers enter 85% of all medical orders into IT systems with the observation that "setting a requirement of 100% is both unrealistic and unachievable." The document for other providers sets a parallel set of standards.

As for why anyone should care about the definition of meaningful user, it's because of the greatest behavior modification tool of all time; money. The federal spending for HIT that is only now trickling – but which will soon begin to gush – will not go to entities that are not certified as "meaningful users."

CMS proposes rules and update for IRFs

The Centers for Medicare & Medicaid Services has proposed a fee schedule for inpatient rehabilitation facilities (IRFs) for fiscal year 2010, which would provide a payment update rate of 2.4%, which the agency's April 29 statement indicates would come to $140 million spread across roughly 1,200 free-standing and in-hospital IRFs.

The statement also notes the agency's intent to revise requirements for pre-admission screening and coordination of care during the stay. CMS states that IRFs would have to document that admittees will "be able and willing to actively participate in an intensive rehabilitation program," and that interdisciplinary teams review each patient's progress weekly.

Acting CMS administrator Charlene Frizzera said in the statement that the proposal is backed by input from the National Institutes of Health and by "input from the rehabilitation community." IRFs will have to demonstrate that 60% of patients in an IRF "had either a principal or secondary diagnosis that falls within one or more of the qualifying conditions."

CMS will accept comments until July 29 and expects to issue a final rule on or before Aug. 1.

Seblelius moves on swine flu outbreak

Kathleen Sebelius, the newly confirmed Secretary of Health and Human Services, wasted no time in setting into motion a plan at the department to buy 13 million treatment courses for several influenza types, including the infamous H1N1, a.k.a., the swine flu for those with no sensitivities as to porcine affective states. However, HHS intends to send 400,000 treatment courses to Mexico, which has been hit hardest to date with the outbreak. The statement does not indicate the department's intent regarding domestic distribution other than to say HHS has distributed 11 million courses.

According to the April 30 HHS statement, the agency has 50 million courses of treatment on hand and can access another 23 million from stockpiles held by the 50 U.S. states. Sebelius said in the statement that the purchase of 13 million additional treatment courses "will allow us to replenish our national stockpile and further ensure we are prepared to provide the American people with the treatments they may need to stay healthy." The purchase is said to cost $251 million.

Insulin pumps subject of recall

Disetronic Medical (Burgdorf, Switzerland) reported last week a recall of Accu-Chek insulin pumps due to a malfunction in buttons that control insulin dosing. The malfunction covers the Spirit pumps with serial numbers between, SN02119552 and SN10006093, all of which are said to have been shipped to the U.S.

Disetronic states that it caught the problem with its in-house quality control system and that patients can tell whether the unit is defective by the audio or vibration alert that should accompany any manual overrides to the pump's automated function. Patients are urged to test the buttons and disconnect the unit should it not react. Users of the Spirit units can call 1-800-778-5095 for a replacement, which the firm says will arrive within two business days.

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