EMR Implementation & HITECH Act Blog

The Acronyms of HITECH: What Do They All Mean? (Part 2)

We ended our blog posts in 2009 addressing a common dilemma:  how do you wade through the alphabet soup of acronyms surrounding the HITECH Act?  A single sentence can contain tons of upper case letters which you may or may not be 100% familiar with.  To help you sort out what all these terms mean, we created a short glossary.   We begin 2010 with Part 2 (Part 1 is here).  Because HITECH-related terminology is evolving, this will be a living document of sorts.   If you see one we missed, or one whose definition has changed, let us know and we’ll do our best to keep it current.

HIE – Health Information Exchange

This is another of those definitions that seems to be in flux.   What a health information exchange does is create an environment that facilitates the exchange of electronic medical records across regional and geographic lines.   An HIE may be a stand-alone entity or Several RHIOs may comprise an HIE, and all the HIEs around the country will make up the NIHN.

HIMSS – Health Information and Management Systems Society

The HIMSS is a 23,000-member group dedicated to improving medical care through the use of health information technology.  While based in Chicago, HIMSS members are actively involved in implementing, developing and improving every aspect of HIT throughout the world.

HIPAA – Health Information Portability and Accountability Act

While most people think of HIPAA as the set of laws that regulates the privacy and security of medical information, it is actually a much broader piece of legislation.  HIPAA rules also regulate:

• how health insurers deal with pre-existing conditions
• the transfer of coverage from one health insurer to another
• the mechanics of the exchange of health information
• claims to Medicare and Medicaid

HIPAA was passed in 1996, and has been constantly amended and changed in the years since.  The HITECH Act, passed in 2009, significantly changed many of the requirements of HIPAA.

HIT – Health Information Technology

HIT is an umbrella term covering any technologies that improve the collection and sharing of health information among doctors, patients, hospitals, insurers and other stakeholders in the health care system.

HITECH ACT – Health Information Technology for Economic and Clinical Health Act

Enacted in 2009 as part of ARRA (see above), the primary purpose of the HITECH Act is to encourage the adoption of EHR/EMR by providing billions of dollars in financial incentives.  The HITECH Act also made significant changes to the security and privacy requirements already in place under HIPAA, expanding their scope and coverage and strengthening penalties for non-compliance.

HITSP – Health Information Technology Standards Panel

The Department of Health and Human Services (HHS) awarded a contract to the American National Standards Institute (ANSI) to establish the HITSP in 2005, in response to then-President Bush’s desire to improve health care through the use of technology.

ANSI, working with HIMSS, consulting firm Booz Allen Hamilton and the Advanced Technology Institute created the HITSP to facilitate cooperation between the public and private sectors and serve as an intermediary when existing standards and laws conflicted.   Its overall goal is to achieve standards for interoperability among all the components of the NHIN.

HL7 – Health Level 7

Health Level Seven is an international non-profit group of scientists and researchers dedicated to creating standards and protocols for the sharing and communication of health information.   Headquartered in Ann Arbor, Michigan, HL7 concentrates its work on the sharing of clinical and administrative data, and is accredited by the the American National Standards Institute (ANSI).

ICD-9 or ICD-10 – International Classification of Diseases

Technically known as the International Statistical Classification of Diseases and Related Health Problems but commonly referred to as the ICD, this is a set of international standards used to classify diseases, injuries and medical conditions.   Each is assigned a unique, six-digit code which is used by doctors throughout the world for a variety of purposes including insurance, billing and public health statistics. It will also be an important part of EHR/EMRs.

The ICD system was created by the World Health Organization and is currently in its tenth version (ICD-10), although in some places ICD-9 is still in use.   A new version is tentatively planned for 2015.

Meaningful Use

When the HITECH Act was passed in 2009, it set forth incentives to be made available for the adoption of EHR/EMRs. To qualify for the incentives, a provider must demonstrate “meaningful use of an approved” EMR/EHR.

The exact definition of meaningful use has not yet been determined.   The ONC (see below) is still creating it with the help of a number of advisory groups and panels.   A good way to track developments on the definition of meaningful use will be to regularly check with the HHS .

NHIN – National Health Information Network

The NHIN isn’t an actual organization or physical thing so much as it is an idea.   Starting in 2004, HHS started looking at how to create a nationwide network in which all health care providers could share health information in a secure environment.

It began by creating a basic architecture, standards and protocols for such a system and then awarding contracts for trial implementations.   HHS wanted to create certain core capabilities such as the correct matching of information to patients and the secure transmission of that data from one place to another.

The NHIN will include sets of rules, protocols and standards to ensure that all the various health information technologies in tens of thousands of doctors offices and hospitals around the country will all work together to achieve the goals of improved patient care and lower costs.

A good analogy here might be the internet.   Millions of different websites and computer applications all work on the internet because they follow certain sets of protocols, rules and conventions that govern how the internet works.

ONCHIT / ONC – Office of the National Coordinator Health Information Technology

Known as both ONC and ONCHIT, the Office of the National Coordinator was created by President Bush in 2004 to coordinate and lead efforts to improve health care in the U.S through the use of health information technology.   The ONC is a part of HHS.   Its mission and responsibilities were expanded significantly by the passage of the HITECH Act. The current national coordinator is Dr. David Blumenthal.

PQRI – Physician Quality Reporting Initiative

PQRI is a voluntary program through which physicians can earn incentive payments from the government for simply reporting quality data on covered Medicare procedures to CMS.   Each year CMS chooses which quality measures will be part of the program.  In 2008, more than 85,000 physicians elected to participate and were awarded more than $92 million in incentive payments.

REC – Regional Extension Center

Think of this as the medical equivalent of the agricultural extension center you call when you have a question about flowers or boll weevils.

The government will be setting up some 70 of these centers around the country.   Their purpose will be to provide help to primary-care physicians as they implement EMR/EHRs.   The government has not yet determined where these centers will be located or how much money they will be supported with (current thinking is $1-2 million per center, to start).

RHIO – Regional Health Information Organization

A RHIO is an organization created to serve as the infrastructure through which health information will be transmitted within a given geographic area and to other RHIOs.   A RHIO will serve as an intermediary between providers, patients, insurance companies and other “stakeholders” who have or need access to medical records.

The RHIO will ensure that the data remains secure, yet available to those organizations who have a legitimate need for it, whether they be local or in another part of the country.

Rich Silverman
PCHS Blogging Team

Photo by Tillwe courtesy of FLick’r under a Creative Commons Share-Alike License

Posted by PC Healthstop Blogging Team