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e-News | June 2014

e-News | Louisiana Health Care Quality Forum - February 2014

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2014 Meaningful Use Efforts Should Continue

On May 20, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) issued a proposed rule that may delay implementation of 2014 edition Certified Electronic Health Record Technology (CEHRT).
In spite of that announcement, eligible providers, hospitals and critical access hospitals are urged to continue current efforts to achieve Meaningful Use (MU), said Nadine Robin, Health IT Program Manager for the Louisiana Health Information Technology (LHIT) Resource Center.
Robin cautioned that the rule is simply a proposal at this time. “This has not been finalized, and we strongly encourage providers to continue their current efforts to attest to Meaningful Use.”
She explained that the proposal is designed to give some flexibility to allow providers participating in the EHR Incentive Program to use the 2011 Edition of CEHRT for calendar and fiscal year 2014.
“If it is finalized, it could mean that some EPs and EHs will be able to attest to Meaningful Use this year using 2011 CEHRT or a mix of 2011 and 2014 technology,” she said. “It may also allow some EPs and EHs to attest this year by meeting the 2013 or 2014 Stage 1 measures even if those providers were scheduled to start Stage 2 this year.”
The proposal, if approved, would be valid only for the 2014 reporting year. In 2015, all EPs will still be required to report using the 2014 Edition CERHT for a full calendar year. It also includes a provision formalizing CMS and ONC’s previously stated intention of extending Stage 2 through 2016 and beginning Stage 3 in 2017.
In the CMS press release announcing the proposed rule, Karen DeSalvo, MD, National Coordinator for Health IT, said, “Increasing the adoption of EHRs is key to improving the nation’s health care system and the steps we are taking will give new options to those who, through no fault of their own, have been unable to get the new 2014 Edition technology, including those at high risk, such as smaller providers and rural hospitals.”
Robin noted that the LHIT Resource Center, as Louisiana’s Regional Extension Center (REC), remains available to assist the state’s eligible health care providers, hospitals and critical access hospitals in understanding any changes to MU rules.
“We are watching this proposal very carefully, and we are prepared to assist our clients in attesting to MU through the EHR Incentive Program regardless of any rule changes,” she said. “For now, our recommendation is to remain focused on your current plan for Meaningful Use in 2014.  For those who need assistance, the LHIT Resource Centers offers a support model to provide additional consultation and guidance regarding Meaningful Use. Find out more about this support by calling 225-334-9299.”
Read the CMS press release here.

Munn: Prepare Now For State’s Hurricane Season
Hurricane season officially began in Louisiana on June 1, and now is the time to prepare for emergency and disaster situations, says Cindy Munn, Quality Forum CEO. She adds that ensuring the availability of personal health information is an important part of those preparations.
“Our organization was born of the destruction wrought by Hurricanes Katrina and Rita in 2005. In those storms, hundreds of thousands of Louisiana residents lost their critical health information as records were destroyed, lost or damaged,” Munn says. “What we learned from that tragic situation is the value of electronic health records and the need for a statewide health information exchange to help ensure that those records are available to our doctors regardless of where evacuations may have sent us.”
The result of the two deadly hurricanes, Munn notes, was a growing emphasis on EHR adoption in the state and the development of the Louisiana Health Information Exchange (LaHIE). She encouraged Louisiana residents to visit with their health care providers to learn more about EHRs and LaHIE.
To download the Quality Forum’s patient guide to EHRs, click here. The patient guide to LaHIE can be downloaded here. To download the Louisiana Emergency Preparedness Guide or to find out how to download the state’s ‘Get a Game Plan’ app for iPhone and iPad, click here.

LaPOST Ready Webinar Series Continues

The Louisiana Physician Orders for Scope of Treatment (LaPOST) Coalition is continuing its efforts to provide education about the LaPOST document in the Greater Monroe area through a series of webinars.
The series is part of the Coalition’s ‘LaPOST Ready’ campaign, which launched April 16 – National Healthcare Decisions Day (NHDD) – in Monroe. The webinars are designed to provide LaPOST education to physicians, nurses, social workers, chaplains, personal care assistants and administrators in the target region.
The webinar series features Susan Nelson, MD, Chair of the LaPOST Coalition and Vice-Chair of the National Physician Orders for Life-Sustaining Treatment (POLST) Paradigm Task Force Executive Committee. Board certified in internal medicine, geriatrics and hospice and palliative medicine, she serves as medical director of Senior Services and PACE Baton Rouge, Franciscan Missionaries of Our Lady Health System and St. Joseph Hospice. She is a fellow of the American College of Physicians and the American Academy of Hospice and Palliative Medicine as well as an advocate for senior health. She works with the Louisiana State Medical Society Council on Public Health and the Louisiana Department of Health.
The webinars are certified by the American Academy of Family Physicians through an educational partnership with the Louisiana Academy of Family Physicians for one hour of CME credit for physicians.
In addition, the program is approved by the National Association of Social Workers -Louisiana Chapter, as authorized by the Louisiana State Board of Social Work Examiners, for one hour of CEU credit, which may be applied toward the continuing education requirements for licensure renewal.
The course is also certified by the Louisiana State Board of Examiners of Nursing Facility Administrators for one hour of continuing education credit.
The webinar series dates and times are as follows:
  • June 12, noon
  • June 17, noon
  • July 8, noon
  • July 22, noon
There is no cost to participate in the webinars. To register, click here.

LHIT Resource Center Offers Medicaid Specialists Program

The Louisiana Health Information Technology (LHIT) Resource Center, through its Medicaid Specialists Program, is providing outreach, technical and support services to help health care providers meet Meaningful Use (MU) objectives.
This program is focused on assisting providers who were previously ineligible for support from Regional Extension Centers for MU initiatives offered by the Office of the National Coordinator for Health Information Technology (ONC).
Specialists are eligible for this program if they meet specific criteria including the 30 percent patient threshold established by the Centers for Medicare and Medicaid (CMS). These specialists must demonstrate each year that at least 30 percent of their patient volume is attributed to Medicaid during a selected 90-day reporting period.
Providers who satisfy the Medicaid thresholds and who are not under another contract for REC direct assistance would qualify for this program, explains Nadine Robin, Health IT Program Manager for the Quality Forum.
“This program enables these health care providers who serve our Medicaid populations to receive the assistance of the LHIT Resource Center in meeting Meaningful Use of electronic health records,” Robin says. “We look forward to working with them as they adopt and implement EHRs for their patients.”
Specialist physicians, dentists, nurse practitioners, certified nurse midwives and certain physician assistants are among those eligible for participation. For more information about the Medicaid Specialists Program and eligibility guidelines, contact Robin at This email address is being protected from spambots. You need JavaScript enabled to view it..

Study: POLST Ensures End-Of-Life Care Wishes Are Met

A study released June 9 by Oregon Health & Science University shows that patients who use Physician Orders for Life Sustaining Treatment (POLST) forms to document their end-of-life care wishes receive the medical care they want in the setting they prefer in their final days.
“This study provides clear evidence that POLST is achieving its mission of honoring the end-of-life care wishes of those with serious, advanced illnesses,” says Susan Nelson, MD, Chair of the Louisiana Physician Orders for Scope of Treatment (LaPOST) Coalition and Vice-Chair of the National POLST Paradigm Task Force. “Where patients die does have an impact on how patients die, and POLST empowers these patients with the ability to document their preferred setting, whether that be in hospice, at home or in a hospital or long-term care facility. For patients facing advanced illnesses, that does provide an immense sense of comfort as they approach the end of life.”
The study, “Association Between Physician Orders for Life-Sustaining Treatment for Scope of Treatment and In-Hospital Death in Oregon,” examines the relationship between POLST utilization and the setting of patients’ care at their time of death. Researchers reviewed the death records of 58,000 people who died in 2010 and 2011 of natural causes in Oregon, where the POLST program was developed in 1991.
Results indicated that the wishes of patients who preferred to avoid hospitalization and documented that preference by choosing to receive Comfort Measures Only (CMO), which refers to the use of medication, positioning, wound care and other measures to relieve pain and suffering, in a POLST form were honored.
Louisiana’s LaPOST program is modeled after that of Oregon. Approved by the State Legislature as Act 954 in 2010, LaPOST is a voluntary, easily identifiable document that translates a patient’s end-of-life wishes and goals of care into a physician order which transfers with the patient across care settings. It is recommended for only for patients with a life-limiting, irreversible illness and takes effect when the patient becomes unable to speak for him/herself.
Louisiana is one of 43 states with an established or developing POLST program. LaPOST, a quality initiative of the Louisiana Health Care Quality Forum, became the 14th POLST program in the country to receive the endorsement of the National POLST Paradigm Task Force in 2012. It has also been endorsed by the Louisiana State Medical Society.
To read the complete study, click here. Additional information about LaPOST can be found at More information about the National POLST program can be found at

PCMH Initiative, REC Featured In Presentation

The Quality Forum’s Patient-Centered Medical Home (PCMH) Initiative and the LHIT Resource Center were featured in a presentation last month by ONC.
“Medical Home Overview” focused on the need to provide comprehensive support beyond the implementation of electronic health records (EHRs) and the ways in which Regional Extension Centers (RECs) can provide this support.
According to the presentation, 36 of the nation’s 62 RECs are participating in the Medical Home Community of Practice (CoP), which is “driving provider practices to attain medical home recognition/accreditation using Meaningful Use functionality.” The Medical Home CoP leverages expertise in MU, EHRs and HIEs, and clinical expertise in care delivery transformation to support practices in becoming PCMHs.
The Quality Forum’s innovative PCMH-REC Practice Engagement Model was cited as an example of how RECs can provide PCMH support. This model is based on three steps: a practice assessment to determine goals and readiness; REC support of health IT optimization and PCMH recognition applications; and the use of clinical health coaches to guide the practice in living the principles of PCMH after recognition is achieved.
According to Bobbie LeBlanc, PCMH Program Manager for the Quality Forum, “When we developed this model, we wanted to focus on providing health IT support and education for practices working to achieve higher levels of PCMH recognition. Health IT is a tool to assist providers in delivering quality care and improving their patients’ outcomes. We wanted to educate providers in how to effectively use that tool to enhance access and continuity of care beyond the requirements of Meaningful Use.”
Nadine Robin, Health IT Program Manager for the LHIT Resource Center, added, “The PCMH model of care is a critical element in care coordination, effective health IT use, care quality and the transition to value-based health care. There is a clear connection between Meaningful Use and PCMH, and that connection is based on supporting providers in developing the ability to use patient and practice data to improve patient care.”
To review the full ONC presentation, click here.

LaPOST Ready Event Planned For Aug. 7

The LaPOST Coalition, in collaboration with the Palliative Care Institute of Southeast Louisiana, has announced that its next ‘LaPOST Ready’ campaign will kick off with a special event at Tchefuncta Country Club in Covington on Aug. 7, 2014.
Registration and lunch will begin at 11:30 a.m. with a one-hour program featuring Susan Nelson, MD, LaPOST Coalition Chair, to follow at noon.
Each LaPOST Ready campaign focuses on providing LaPOST education to health care professionals, social workers and chaplains in a target area of the state. Greater Baton Rouge and the Acadiana region have been declared ‘LaPOST Ready,’ and a campaign in the Greater Monroe area is currently underway.
This activity has been reviewed and is acceptable for up to one prescribed credit by the American Academy of Family Physicians through an educational partnership with the Louisiana Academy of Family Physicians.
This program has also been approved for one-hour general credit of continuing education contact hours by the National Association of Social Workers, Louisiana Chapter, as authorized by the Louisiana State Board of Social Work Examiners, and may be applied toward the continuing education requirements for licensure renewal.
One contact hour for this continuing education offering will be awarded by?St. Tammany Parish Hospital, an approved provider of nursing continuing education by the Louisiana State Board of Nursing, LSBN CE Provider Number 26.
Online registration for the event will be made available via the LaPOST website in the coming weeks. Seats may be reserved in advance by contacting Monique Tyler via email at This email address is being protected from spambots. You need JavaScript enabled to view it..

Deadline Nears For PCMH Recognition From NCQA

Health care providers planning to apply for PCMH recognition under the National Committee for Quality Assurance (NCQA) 2011 version have until June 30, 2014, to purchase the 2011 Survey Tool.
NCQA announced in March that it had released the latest round of its PCMH recognition standards, titled PCMH 2014. Providers must purchase the 2011 Survey Tool prior to June 30 to retain the option of choosing whether to pursue NCQA recognition under the 2011 program or the 2014 program. After March 31, 2015, only the new survey tool will be accepted.
PCMH 2014, according to NCQA, “retains strengths of earlier NCQA standards, including alignment with contemporary federal requirements for meaningful use of health IT, now Meaningful Use Stage 2.”
Among the new requirements are:
  • Integration of behavioral health
  • Care management focus on high-need populations
  • Enhanced emphasis on team-based care
  • Alignment of improvement efforts within the Triple Aim
  • Sustained transformation
The Quality Forum, approved as a Sponsoring Organization by NCQA in July 2012, offers special assistance to practices seeking NCQA recognition. These services include assessment; training; project management; quality assurance and quality improvement plan design and development; policy and procedure templates; practice facilitation; practice and workflow redesign; education and outreach; and assistance with applications for recognition.
To download the NCQA’s 2014 and/or 2011 PCMH standards and guidelines, click here. To learn more about PCMH services available through the Quality Forum, click here or email This email address is being protected from spambots. You need JavaScript enabled to view it..

ONC Announces “Functional Realignment”

National Coordinator for Health IT Karen B. DeSalvo, MD, announced via an internal memo in May that ONC will adopt a “flatter and more accountable reporting structure” to address issues such as interoperability, care transformation, data utilization and quality measures.
Noting that ONC marked its 10th year in April, DeSalvo wrote, “Now as we pivot to a new decade, these few strategic, organizational changes allow us to better align the agency to meet the needs of the future. This functional realignment will improve the overall effectiveness and efficiency of ONC by combining similar functions, elevating critical priority functions, and providing a flatter and more accountable reporting structure. In addition, this realignment will support our focus on developing and implementing an interoperability roadmap, supporting care transformation, and establishing a framework to support appropriate use of health data to further meaningful consumer engagement, system-level quality and safety of care, improvements in the public’s health, and advancements in science.
These changes are designed to “better align the agency to meet the needs of the future,” DeSalvo added.
Input on the realignment was sought from the agency’s senior team, prior ONC leaders and stakeholders “within and outside of HHS,” according to the memo.
To review the details of the restructuring, including the specific duties and responsibilities of each agency, click here.

CMS Posts 2014 Update Of eCQMs

CMS announced June 2 that the annual update of the 2014 electronic clinical quality measures (eCQMs) for eligible professionals and the specifications for electronic reporting are now available.
The announcement included statements from ONC encouraging the implementation and use of the updated electronic specifications of the CQMs finalized in the Stage 2 rule for the 2015 EHR Reporting Period since the updates include updated terminologies, critical logic corrections and intent clarification.
CMS cautions EPs that the 2014 updated specifications cannot be used prior to the 2015 EHR reporting period.
The updates as well as resources and guidance can be found on the CMS eCQM Library page.

ONC Releases EHR Adoption Rates Among ACHs In Louisiana

According to an ONC data brief issued in May, 49.2 percent of Louisiana’s non-federal acute care hospitals (ACHs) are now using at least a basic EHR system.
The national average for basic EHR use among non-federal ACHs is 59.4 percent, the data brief states. Hawaii, South Dakota and North Dakota had the highest percent of basic EHR adoption, while Utah, Kansas and Nebraska had the lowest.
In 2013, nearly six in ten non-federal CAHs had adopted at least a basic system with clinician notes. This is a 34 percent increase from the previous year and a more than five-fold increase since 2008, ONC notes.
“In addition, a vast majority of acute care hospitals – 93 percent – possessed EHR technology certified as meeting federal requirements for Meaningful Use objectives,” the report states.
ONC reports also that EHR adoption trends indicate increasing use of advanced functionality. Hospital adoption of comprehensive EHR systems has increased eight-fold since 2009, according to the data brief.
ONC defines a non-federal ACH as “acute care general medical and surgical, children’s general and cancer hospitals owned by private/not-for-profit, investor-owned/for-profit or state/local government,” and adds that this definition “is more consistent with the population of hospitals eligible for federal health IT adoption incentives.”
Read the complete report here.

    • Bobbie LeBlanc, PCMH Program Manager, penned a Quality Forum Blog post, “The Truth About The Patient-Centered Medical Home Model,” on June 4. The blog generated much attention across social media platforms with its link re-Tweeted by ONC and others. The post was also included in the June 4 edition of “The EMR Daily,” a daily digital newspaper that shares top health care-related stories. Read the blog post here, or click here to see it featured in “The EMR Daily.”
    • The LHIT Resource Center, in collaboration with Magellan Health, will provide education for behavioral health providers about Meaningful Use in Shreveport and Baton Rouge. The Shreveport session is scheduled for 3:30-6:30 p.m., June 25, in the large meeting room of the Hamilton Branch Library, 2111 Bert Kouns Industrial Loop. The Baton Rouge session is set for 9 a.m.-noon or 1:30-4:30 p.m., June 27, in the Desoto Training Room at Magellan Health Services, 10000 Perkins Rd., Ste. 500. For information, contact Nadine Robin, Health IT Program Manager, at This email address is being protected from spambots. You need JavaScript enabled to view it..
    • John Fielding, Analytics Project Manager for the Quality Forum, will present, “Promote Yourself: Sharing Career Goals With Your Boss,” at the July 9 meeting of the Baton Rouge Chapter of the Professional Association for SQL Server.
    • Karen B. DeSalvo, MD, MPH, MSc, National Coordinator for Health Information Technology and former Quality Forum Board President, will be the featured speaker at the Louisiana Hospital Association’s Annual Meeting and Summer Conference in Orange Beach, Ala., July 21-23. Her remarks will focus on the use of health IT as a key lever in achieving the Triple Aim. Other speakers will include R. Lawrence VanHorn, PhD, MPH, MBA, Associate Professor of Economics and Management and Executive Director of Health Affairs at Vanderbilt University’s Owen Graduate School of Business, and former U.S. Assistant Secretary of Health and Human Services Ben Sasse, PhD, President and Professor of History at Midland University. Additional event and registration details can be found here.
    • The Quality Forum, the LHIT Resource Center and LaHIE were referenced in a HIMSS Blog post written by Lynn Witherspoon, MD, CMIO, Ochsner Health System. The post discusses Meaningful Use measures, patient engagement and the development of Louisiana’s health IT infrastructure. Read the post here.
    • The Quality Forum was referenced in a blog post published May 23 by North Oaks Obstetrics and Gynecology, located in Hammond. The post announced that the practice, led by COO Lemar Marshall, a Quality Forum Board member, is now an application center for Medicaid. The post also notes that the practice “has been recognized for its leadership in technology implementation and has recently been selected by the Louisiana Health Care Quality Forum to qualify for NCQA certification” as a PCMH. Read the post here.
    • Quality Forum CEO Cindy Munn is quoted in an article published May 23 by Houma Today in Houma and the Daily Comet in Lafourche Parish. The article features the Houma-based Cardiovascular Institute of the South, which has developed an innovative EHR system designed specifically to improve care for cardiology patients. Read the full article here or here.
    • selected a Tweet issued by the Quality Forum as one of its HIE “Hashtag Highlights” in May. The Tweet featured a link to the Quality Forum’s latest consumer-focused video about LaHIE. See the list of highlighted Tweets here.
    • The Healthcare Journal of New Orleans and the Healthcare Journal of Baton Rouge published in their May editions an article by Quality Forum CEO Cindy Munn. The article focused on the annual HIMSS Conference held in Orlando, Fla., in February, and identified current and emerging trends in health IT. The article includes comments by Karen DeSalvo, MD, National Coordinator for Health IT; Brian Richmond, CTO for the Quality Forum; Nadine Robin, LHIT Resource Center Health IT Program Manager; andMarcia Blanchard, Vice President of Operations for the Quality Forum. Read the article here.
    • In response to a request from the Senate, the Louisiana State Board of Medical Examiners has added links to information regarding end of life care in Louisiana to its website. The resources listed include a link to the LaPOST website. See the announcement here.
    • National Coordinator for Health IT Karen B. DeSalvo, MD, has been named to Becker’s Hospital Review’s “16 of the Smartest People in Health IT.” The list recognizes “the health IT industry’s brightest leaders,” each of whom was selected through an editorial review process. The list includes brief bios of each individual, and DeSalvo’s includes reference to her past leadership of the Quality Forum. Read the complete list here.
    • Quality Forum CEO Cindy Munn and Health IT Program Manager Nadine Robin were included in the May 2014 newsletter from the Louisiana Chapter of HIMSS. LaHIMSS included photos of Robin, the organization’s President-Elect, at the National HIMSS Conference in Orlando, Fla., and noted that she and Munn were also speakers at the event. Read the newsletter here.

    e-News aims to bring you a monthly summary of news about the Forum, its initiatives and related topics as we work together to shape health care in Louisiana. Your comments regarding current stories as well as ideas for future content are appreciated. Please address your feedback to Linda Morgan at This email address is being protected from spambots. You need JavaScript enabled to view it..