2010-08

Calling for the Adoption of Health Information Technology, E-Prescribing and Electronic Health Records

Senator Juan M. Pichardo (RI)

Short Title: Electronic health records
WHEREAS , significant challenges face the current health care system, including loss of physician time due to access barriers, poor coordination between health care providers, inefficiency and waste as a result of unneeded and redundant tests, excessive paperwork, and increasing difficulty in managing the growing volume of health information; and

WHEREAS, despite advances in technology, most medical providers use medical systems based on paper and have not embraced and utilized computer technology; and

WHEREAS, Health Information Technology (HIT), such as electronic medical records, can greatly improve the quality and safety of care that patients receive, decrease health disparities, help promote efficiencies in medical practice, improve access to care via telemedicine, and allow for improved tracking of health care data and trends; and

WHEREAS, the federal government has created incentives and programs to help medical providers across the country make the switch to electronic medical systems appropriating more than $25 billion to support HIT; and

WHEREAS, according to the United States Department of Health Services website, Electronic Health Records can provide many benefits for providers and their patients including providing;

*Providers information about their patient’s health history, before they walk into the examination room so that they can provide the best possible care.

*Better access to information so thatthe information providers need, can be shared more easily, among doctors’ offices, hospitals and other health care systems providing better coordination of care to diagnose health problems earlier and improve the health outcomes of their patients.

*Patients the opportunity to take a more active role in their health, and the health of their families, by enabling them to receive electronic copies of their medical records, to share securely over the Internet with their families; and

WHEREAS, the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH) Act enacted under the American Recovery and Reinvestment Act (ARRA) specifies that HIT provisions provide assistance and technical support to providers; and

WHEREAS, this assistance and support requires enabling coordination in and among states, to assure the workforce is properly trained and equipped to be “meaningful users” of Electronic Health Records (EHRs); and

WHEREAS, in order for providers to become comfortable and adept at using EHRs, the federal government has made training “meaningful users” a priority; and

WHEREAS, according to the Centers for Medicare and Medicaid Services (CMS), the Recovery Act specifies three main components of Meaningful Use to encourage quality care:

*The use of a certified EHR in a meaningful manner (e.g.: e-Prescribing);

*The use of certified EHR technology for electronic exchange of health information to improve quality of health care; and

*The use of certified EHR technology to submit clinical quality and other measures.; and

WHEREAS, funding for the HITECH grant program is provided to establish Health Information Technology Regional Extension Centers to offer technical assistance, and guidance to support and accelerate health care providers’ use of EHRs; and

WHEREAS,quality care must include recognition of barriers to access many patients face like “prior authorization”; and

WHEREAS, a physician looking into an electronic health record or e-prescribing system should be aware of these “prior authorization" requirements; and

WHEREAS, information a physician needs to meet the requirements of the “prior authorization” should be available electronically so that when the physician is sitting with the patient they can discuss treatment options; and

WHEREAS, States are primarily focused on planning and financing health information exchange, and trying to encourage the use of health information technology (HIT); and

NOW, THEREFORE, BE IT RESOLVED, that the National Hispanic Caucus of State Legislators (NHCSL) supports legislation to improve the adoption rates of EHRs, and elected officials should encourage secure and private data exchange that ensures:

*The primacy of the physician patient relationship
*Quality outcomes
*Transparency
*Meaningful cost savings through reduction of fraud, waste and duplication
*Prevention and wellness; and

BE IT FURTHER RESOLVED,that the NHCSL believes that state legislatures should require that all electronic prescribing devices used in their States shall;

*Align health information technology systems with the provision of quality care;
*Reduce administrative barriers to timely and effective care;
*Ensure that appropriate information regarding medical decisions is available at the time and place of care;
*Improve the coordination of care and information between hospitals, patients, physicians, payers, laboratories and pharmacies through a secure and effective infrastructure for the exchange of health care information;
*Allow for access to data for research purposes without compromising patient confidentiality
*Ensure that medical decisions remain a joint decisions between a patient and his or her health care professional;
*Otherwise positively influence the quality, safety and efficiency of health care provided to the citizens of their state; and

BE IT FURTHER RESOLVED, that the NHCSL supports electronic prescribing devices that support “meaningful use” of electronic health records as required as part of the ARRA; and

BE IT FURTHER RESOLVED, that the NHCSL believes that state legislatures should implement policies and procedures that advance telemedicine and remote monitoring applications under the state Medicaid programs, third party payment mechanisms and other state programs to improve access to quality care; and

BE IT FURTHER RESOLVED, that the NHCSL believes that states shall provide financial incentives to Medicaid providers as described in Section 4201 of the ARRA and pursue available Federal Financial Participation for these incentives and the state’s administrative costs associated with the program; and

BE IT FURTHER RESOLVED, that the NHCSL believes that All Prescription Drug Orders communicated by way of Electronic Transmission shall:

*Be transmitted directly to a Pharmacist or Certified Pharmacy Technician in a licensed Pharmacy of the patient’s choice with no intervening Person having access to the Prescription Drug Order;

*Identify the transmitter’s phone number or any other suitable means to contact the transmitter for verbal and/or written confirmation, the time and date of transmission, and the identity of the Pharmacy intended to receive the transmission, as well as any other information required by federal or state law;

*Be transmitted by an authorized Practitioner or the designated agent of the prescriber;

*Be deemed the original Prescription Drug Order, provided it meets the requirements of this subsection; and

BE IT FURTHER RESOLVED, the NHCSL believes all Electronic Transmission Devices used to communicate a prescription to a Pharmacist or Certified Pharmacy Technician shall:

*Allow any legal Prescription Drug Order to be written and entered into the device without interference or limitations, including a medication limited pick list or multiple messaging, prior to submission to a Pharmacist or Certified Pharmacy Technician;

*Allow the prescription to be written through a neutral and open platform that does not use any means, program, or device, including, but not limited to, advertising, instant messaging, and pop up messaging, to influence or attempt to influence, through economic incentives or otherwise, the prescribing decision (as defined in clause (f) of the Definitions) of a health care professional at the point of care (as defined in clause (e) of the Definitions) if such means, program, or device is triggered by, initiated by, or is in specific response to, the input, selection, and/or act of a prescribing health care professional or his agent prescribing a covered outpatient drug or selecting a pharmacy for a patient.

Sponsored By: Senator Juan M. Pichardo (RI)

THIS RESOLUTION WAS ADOPTED BY NHCSL AND RATIFIED AT ITS ANNUAL MEETING HELD IN SAN ANTONIO, TEXAS NOVEMBER 13TH, 2010.