VITL Middlebury, Vt. (August 12) – Vermont patients are beginning to see results from a $27 billion federal program that offers incentives for physician practices and hospitals to use electronic health records systems, according to US Senator Patrick Leahy. Those benefits include Vermonters receiving more reminders about important preventive care. Senator Leahy spoke during a visit to Middlebury Family Health Friday, the first Vermont physician practice to meet all of the federal program’s criteria for improving patient care using its electronic health records system.”I am delighted that this targeted federal investment has enabled Middlebury Family Health to become the first Vermont practice to receive incentive payments from Medicare for using an electronic health record system,” Leahy said. “Better records mean better patient care and patient safety for Vermonters. With breakthroughs like this, we are beginning to shift to a higher gear in health reform. The federal partnership with Vermont Information Technology Leaders and local physician practices has the potential to benefit every Vermonter. Vermont has been in the front ranks of health care reform, and Middlebury Family Health’s adoption of an electronic health record system is an excellent example of this leadership.” As part of the American Recovery and Reinvestment Act of 2009, Congress appropriated $27 billion to fund the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs. To participate in either of the programs, eligible health care professionals must use federally-certified EHR technology, and meet a number of criteria for becoming “meaningful users” of EHRs and improving patient care. Once documenting that they have achieved meaningful use, eligible professionals receive up to a total of $44,000 in incentive payments from Medicare over the five years they choose to participate in the program or up to $63,750 in incentive payments from Medicaid over the six years they choose to participate in the program. Hospitals may also participate in the programs, receiving incentives based on a number of factors, beginning with a $2 million base payment.All four physicians at Middlebury Family Health recently achieved meaningful use of their EHR, and each has received the maximum first year incentive payment of $18,000 from Medicare, making them the first eligible professionals in Vermont to do so. The physician practice will use the federal funds to pay for the EHR technology and to continue to make investments in improving patient care. “Our electronic health records system has streamlined communication in the office between physicians, nurses, and other staff,” said Eileen Doherty Fuller, MD, a partner at Middlebury Family Health. “We’ve also greatly enhanced communications with our patients. Using the EHR, we can better track which patients are overdue for physicals, mammograms, and checkups for high blood pressure, diabetes, and high cholesterol.” When the electronic health records system flags an overdue preventive service, Middlebury Family Health contacts the patient to schedule an appointment. “Often patients don’t realize it is time for them to come in, so we are able to be more proactive about reminders,” Dr. Fuller said.Other general criteria for meaningful use that directly affect patient care include: eprescribing and the ability to immediately check drug-to-drug and drug allergy interactions; maintaining up-to-date patient medical problem lists and medication lists; and providing patients with a clinical summary of their visit, including any changes to medications, instructions and other relevant information. One feature of Middlebury Family Health’s electronic health record system that has been particularly beneficial is its ability to track whether ordered lab tests were actually completed, Dr. Fuller said. If a patient fails to show up for a scheduled test, the EHR will alert physicians who can follow up with the patient.Middlebury Family Health has also met the standards for being a patient centered medical home, and attained the highest level status in that National Committee for Quality Assurance program, Dr. Fuller noted. As a result, Middlebury Family Health will receive the highest level of payment for participating in the Vermont Blueprint for Health program. “Without the EHR, we could have never done that,” she said.”Middlebury Family Health worked with VITL and the state of Vermont using collaborative workgroups for meaningful use and the medical home. We included four staff members and two doctors to learn and implement this system. Joining me on this team were Dr. Linn Larson, Medent Specialist Michelle Clark, and Office Manager Stacy Ladd. They kept the staff involved and excited throughout the process. In addition, Christine Fuller and Connie Billings were an important resource to the team. The efforts of all our employees and this core team were critical to our success,” Dr. Fuller said. The other two physicians in the practice areJean Andersson-Swayze, MD, and Dayle Klitzner, MD. Assistance from VITLPhysician practices and hospitals around the country receive assistance in implementing EHR technology and achieving meaningful use from 62 non-profit regional extension centers funded by the federal government. Vermont Information Technology Leaders, Inc. (VITL), an independent non-profit organization based in Montpelier, is the only such center serving Vermont.VITL’s staff worked with Middlebury Family Health to implement its EHR system and connect it to the Vermont Health Information Exchange, a secure statewide health data network operated by VITL. Middlebury Family Health’s four physicians received information and guidance from VITL on achieving meaningful use and qualifying for federal incentive payments.”VITL congratulates Middlebury Family Health for being the first Vermont practice to achieve meaningful use. While you are in the vanguard, there are many other practices following in your footsteps,” said David Cochran, MD, VITL’s president and CEO. “We’re working with more than 750 of the state’s 1,000 primary care providers and expect that Vermont will have one of the highest percentages of health care providers in the country achieving meaningful use. That’s great news for Vermont patients and the state’s health care reform efforts,” he said.The transition to advanced electronic health records systems is also happening in the state’s 14 hospitals, Dr. Cochran noted. Copley Hospital in Morrisville announced on June 29 that it was the first hospital in Vermont to achieve meaningful use. VITL is working with Copley and the rest of Vermont’s hospitals on meaningful use and health information exchange.VITL assisted Porter Medical Center with implementation of the hospital’s new EHR system, which went live on August 1, as well as the installation of a lab system interface to the Vermont Health Information Exchange so that Middlebury Family Health and other physician practices in the hospital’s service area can receive lab results immediately in electronic format.”Through the efforts of Porter Medical Center and area physician practices, including Middlebury Family Health, Addison County is well on the way to becoming one of the most connected communities in Vermont for medical records,” Dr. Cochran said. “Patients in the Middlebury area will experience better health care because of the increased use of health information technology, everything from smoother check-in at the front desk to greater information sharing among authorized providers, which will result in fewer duplicated tests and quicker diagnoses of medical problems.”
Board supports Foundation plan to amend the IOTA rule April 15, 2001 Managing Editor Regular News Board supports Foundation plan to amend the IOTA ruleMark D. Killian Managing Editor The Board of Governors has given its unanimous support to a Florida Bar Foundation plan to open the IOTA program to financial institutions other than banks and require those holding the trust accounts to pay interest rates or dividends commensurate with those offered to their non-IOTA depositors. Foundation President Ham Cooke told the Board of Governors March 30 in Melbourne that the proposed amendments to the IOTA rule which must be approved by the Supreme Court have the potential to double the money generated by the IOTA program. Cooke said low interest rates and high service charges over the past 10 years have reduced IOTA income from about $19 million per year to $11 million, forcing the Foundation to cut its legal aid to the poor grants by 32 percent over the past two years. “Our board has taken that very, very seriously,” Cooke said. “We wanted to do something to be as proactive as we could in trying to increase the return that IOTA is receiving.” To do that, Cooke said, the Foundation will soon petition the court to amend the IOTA rule to allow financial services companies such as Morgan Stanley Dean Witter or Merrill Lynch to hold IOTA accounts. The change also would require any institution that wants to handle IOTA accounts to place IOTA account funds in products paying the same market rate of interest or dividends available to non-IOTA depositors when IOTA accounts meet the same balance and other requirements. Authorized investments would include FDIC insured accounts, daily bank repurchase agreements (REPOs) or money market funds. Currently, IOTA funds can only be held in federally insured checking accounts or REPOs. The IOTA rule amendments being proposed by the Foundation make no change in the current requirement that all nominal or short-term client or third-person trust funds be invested for IOTA’s benefit. But, as always has been the case, attorneys and firms have a responsibility to make large or long-term trust deposits productive for clients whenever practical. Cooke said adopting the change could generate as much as $25 million annually for the Foundation and “allow us to then fund legal services at the level we did 10 years ago.” Bar President-elect Terry Russell urged the board to support the Foundation’s plan, which he said would “enable the Foundation to regain its footing” and provide more complete provision of resources to legal service organizations. Russell noted that since IOTA’s inception, the program has generated more than $156 million for legal aid, administration of justice, and law student assistance programs. In putting the plan together, Cooke said the Foundation worked to put the onus of meeting the new standards on the financial institutions and the Foundation, not the lawyers. Even by requiring that IOTA accounts earn the highest interest rate or dividend available to non-IOTA depositors with comparable balances at the same bank or financial services company, IOTA still is voluntary for institutions, Cooke said. But, by meeting the interest or dividend standard, banks would become eligible to hold IOTA accounts, and lawyers and firms would be required to deposit IOTA funds only in eligible institutions. As part of the plan, the Foundation also will independently work with banks and financial service companies to develop appropriate products which comply with the IOTA rule, Cooke said. That will include providing the banks with computer and technical support needed to remit IOTA earnings to the Foundation and conduct the required reporting. The Foundation, not the lawyer, will be responsible for monitoring usage of banks’ and financial services companies’ existing products available to non-IOTA depositors, with respect to rates being paid on individual attorney and law firm IOTA accounts as reported by the Foundation on IOTA remittance reports, in order to determine compliance with the IOTA rule. The proposal calls for no action to be required of law firms by the proposed amendments to monitor their institution’s compliance, and unless an attorney’s or law firm’s bank becomes ineligible to hold IOTA funds because of its unwillingness to place IOTA account funds in products in compliance with the rule. In that instance, the Foundation would advise the attorney or law firm that their financial institution had become ineligible to hold IOTA funds.