The Impact of HITECH on EHR Implementation

Software Advice, a trusted resource for buyers of software, recently published findings from a three-year study following the changing demand drivers among prospective buyers of eclectronic health record (EHR) software.

The study captured data over two sample periods: Q1 2010 (shortly after the HITECH Act was signed into law) and Q1 2013. In both sample periods, the reasons providers expressed interest in purchasing EHR software broadly fell into the following categories:

• Replacing paper records;
• Replacing existing EHR software;
• Opening a new practice;
• Replacing other software that wasn’t specifically designed for medical records; or
• Some combination of the above.

For both sample periods, replacing paper records was the most-mentioned reason for EHR purchases. However, the percentage of practices replacing paper records fell significantly from 2010 to 2013, while the percentage of respondents replacing existing software grew by almost 50 percent.

These findings seem to validate a hypothesis that the HITECH Act spurred some practices to adopt EHRs too hastily. For providers, this highlights the importance of having a rigorous selection process in place before making a purchase.

Digging deeper into the data allows us to determine why practices are replacing existing EHRs.

Mentions of being “unhappy with current EHR” grew by 11 percent from 2010 to 2013. Additionally, concerns with cost rose significantly, from only one mention in 2010 to being mentioned by one out of every eight participants in 2013. Customer service concerns grew by nearly 50 percent.

Replacing Paper
The percentage of buyers replacing paper charts decreased from 64.9 percent in 2010 to 50.9 percent in 2013.

In both 2010 and 2013, the top reasons practices mentioned for switching from paper to electronic records had to do with the general benefits of a paperless environment – decreasing paperwork, improving efficiency, and becoming more organized. These motivations suggest practices are interested in more than just stimulus dollars; they also seem to recognize the inherent value of electronic records.

Among potential EHR buyers, we observed a decline in the proportion of practices transitioning from paper to electronic records, contrasted with an increase in the proportion of practices replacing existing software. What our data points don’t show, by virtue of only including buyers in the market for an EHR, are the many providers who are not replacing their EHR solutions – those who have successfully implemented electronic records with great benefit to their practices.

With EHR replacements on the rise, we conclude by emphasizing the need for practices to perform due diligence before making a purchase decision. Careful research can be awarded with a system that contributes to improved patient outcomes as well as increased financial health for practices.


David Fried originally contributed this report to Software Advice, where he currently covers medical practice management, the EMR industry, and political and regulatory issues affecting doctors. View the full report, including methodology and limiting factors, here: Four Years Later: The Impact of the HITECH Act on EHR Implementations.

Quotes from an OT User of Electronic Occupational Therapy Documentation

One of our Chart Links Rehabilitation Software users, Debbie Flaspohler, OTR, MOT, CLT and manager of occupational therapy at Margaret Mary Community Hospital in Batesville, Ind., was recently quoted in an article called “Meaningful Change,” written by Teresa Mcusic from  Reveiw some of her quotes extracted below, or, read the full article.

Debbie Flaspohler, OTR, MOT, CLT, manager of occupational therapy, Margaret Mary Community Hospital in Batesville, Ind., says she was comfortable using her facility’s Chart Links LLC rehabilitation software within a few weeks. “It was an easy program to move around in,” she says. “And Chart Links did a good job of coming and doing orientation. A team came and spent about a week with us. Also, they have a help desk, so when we got stuck, we could call them.”

The legibility and standardization of electronic records are major benefits over hand-written paper charts, therapists say. The electronic documentation also is more concise, Flaspohler says. “It looks more professional,” she says. “These are a legal document used for reimbursement. Clarity and accuracy are really important.”

Such precision also helps with more consistency among healthcare team members, Flaspohler says. “It helps everybody document the way they are supposed to,” she says. “It’s not black and white — you can modify the way you want to — but it makes you fill out what you need to fill out.”

The systems also can be tailored to include information on interventions for patients with conditions the therapists don’t often encounter, Flaspohler says. “For diagnoses you normally don’t see, you can pull in components from the system for a segment on that,” she says.

For more information about Chart Links Rehabilitation software for occupational therapists, visit our website.

CMS & ONC Issue Regs Proposing Definition of Meaningful Use and Setting Standards for EHR

The Centers for Medicare & Medicare Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) encourage public comment on two regulations issued on December 30, 2009 that lay a foundation for improving quality, efficiency and safety through meaningful use of certified electronic health record (EHR) technology. The regulations will help implement the EHR incentive programs enacted under the American Recovery and Reinvestment Act of 2009 (Recovery Act).

A proposed rule issued by CMS outlines proposed provisions governing the EHR incentive programs, including defining the central concept of “meaningful use” of EHR technology.

An interim final regulation (IFR) issued by ONC sets initial standards, implementation specifications, and certification criteria for EHR technology.  Both regulations are open to public comment.

The Recovery Act established programs to provide incentive payments to eligible professionals and eligible hospitals participating in Medicare and Medicaid that adopt and make “meaningful use” of certified EHR technology.  Incentive payments may begin as soon as October 2010 to eligible hospitals.  Incentive payments to other eligible providers may begin in January 2011.

Meaningful Use for Therapists

So far, recommended meaningful use measures for electronic health records (EHR) have focused on primary care providers.  Hopefully, that will change soon after the Health Information Technology (HIT) Policy Committee meets in Washington later this month.  At the two-day meeting, the HIT Policy Committee will hear testimony on how meaningful use might affect non-physician practitioners.

Under the American Recovery and Reinvestment Act (ARRA), the Federal Advisory Committee Act (FACA) mandated the creation of the HIT Policy Committee.  This committee is charged with making recommendations to the National Coordinator for HIT on issues pertaining to health information technology.

CCHIT to Seek EHR Vendor Input on Town Call Meeting

The Certification Commission for Health Information Technology (CCHIT®), a nonprofit organization with the public mission of accelerating the adoption of health IT, will host a Town Call tomorrow for the vendor and developer community tomorrow.  Chart Links Chief Operating Officer, Jim Hammer, will participate.  On the call, CCHIT will gather input on the details and timing of its planned new paths to certification of electronic health record (EHR) technologies, with the goal of supporting more rapid, widespread adoption and meaningful use under the American Recovery and Reinvestment Act of 2009 (ARRA).

“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,” said Mark Leavitt, M.D., Ph.D., Commission chair.  “CCHIT has analyzed the recommendations of the Federal HIT Advisory Committees and is preparing to offer new paths to certification beginning this October.”

Besides updating and enhancing its current certification program for comprehensive EHRs in Ambulatory, Inpatient, and Emergency Department settings, the Commission plans to launch a more limited, modular inspection program for EHR technology, focusing only on compliance with ARRA-required standards.

During the event, planned for September 3 at 12:00 PM Central time, concepts and some details of these two programs will be discussed.  Participants will be invited to submit questions and comments online, and respond to polling regarding their interest and readiness for participation in the process.

Information about the free Town Call is available at

More information on CCHIT and CCHIT Certified® products is available at and

Therapists Now Required to Notify Individuals of Health Information Breaches

The U.S. Department of Health and Human Services (HHS) has issued a rule requiring that individuals be notified of breaches of their health information. 

These “breach notification” regulations implement provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act, passed as part of the American Recovery and Reinvestment Act of 2009 (ARRA).

The regulations, developed by the HHS Office for Civil Rights (OCR), require health care providers and other HIPAA covered entities to promptly notify affected individuals of a breach, as well as the HHS Secretary and the media in cases where a breach affects more than 500 individuals.  Breaches affecting fewer than 500 individuals will be reported to the HHS Secretary on an annual basis. The regulations also require business associates of covered entities to notify the covered entity of breaches at or by the business associate. 

The regulations were developed after considering public comment received in response to an April 2009 request for information and after close consultation with the Federal Trade Commission (FTC), which has issued companion breach notification regulations that apply to vendors of personal health records and certain others not covered by HIPAA.

To determine when information is “unsecured” and notification is required by the HHS and FTC rules, HHS is also issuing in the same document as the regulations an update to its guidance specifying encryption and destruction as the technologies and methodologies that render protected health information unusable, unreadable, or indecipherable to unauthorized individuals.  Entities subject to the HHS and FTC regulations that secure health information as specified by the guidance through encryption or destruction are relieved from having to notify in the event of a breach of such information.  This guidance will be updated annually.

The HHS interim final regulations are effective 30 days after publication in the Federal Register and include a 60-day public comment period.  For more information, visit the HHS Office for Civil Rights web site at

No Final Definition of EHR Meaningful Use until Spring of 2010

We’ve been anxiously awaiting a final definition for “meaningful use” of electronic health records (EHR) to determine which hospitals and providers will be eligible for Medicare and Medicaid incentive payments under the American Recovery and Reinvestment Act of 2009.  However, in a press conference on August 20th, Dr. David Blumenthal, the national coordinator for health information technology, predicted that the final definition will not be available until the middle or end of spring in 2010.  A preliminary definition of “meaningful use” is scheduled to be issued by the end of 2009 with a 60-day comment period.