Local Health Departments' Input on EHRs Sought

NACCHO, the National Association of County and City Health Officials, wants feedback on their "meaningful use" of electronic health records by tomorrow so it can submit comments to the Center for Medicaid and Medicare Services. Who is left to provide the feedback is another question.

NACCHO, the National Association of County and City Health Officials, has asked the local health departments it represents to provide feedback on their "meaningful use" of electronic health records by tomorrow so it can submit comments to the Center for Medicaid and Medicare Services (CMS). CMS' EHR incentive program will provide payments to professionals and eligible hospitals participating in Medicare and Medicaid for meaningfully using EHRs, and some local health departments could be funded, according to NAACHO.

Who can provide the feedback is another question. NACCHO released results of a survey on March 1 that showed local health departments lost 16,000 jobs in 2009, while reports from Trust for America's Health and the Robert Wood Johnson Foundation indicated federal spending on public health has been flat for nearly five years as states cut nearly $392 million from public health programs. Combined with 7,000 jobs cut by local health departments in 2008, NACCHO estimates about 15 percent of the local public health workforce has disappeared in the past two years.

"While local health departments will do the best job they can with the resources available to them to protect Americans from public health threats, these data sound a warning," NACCHO Executive Director Robert M. Pestronk said. "The cumulative effects of budget cuts and job losses have taken a major toll on the ability of health officials to respond not only to large-scale emergencies and disease outbreaks like H1N1 influenza, but to the everyday situations for which the health department is the first line of defense."

The EHR information is needed because Congress specified three types of requirements for meaningful use:

1. Use of certified EHR technology in a meaningful manner (for example, electronic prescribing);
2. That the certified EHR technology is connected in a manner that provides for the electronic exchange of health information to improve the quality of care; and
3. That in using certified EHR technology, the provider submits to the HHS secretary information on clinical quality measures and such other measures selected by the secretary.

"Your [department] will be affected by all three elements in this program, even if you do not provide comprehensive primary care. For example, [eligible professionals] and hospitals will be required to develop the capability to electronically exchange (send and receive) data with public health," the association said. "NACCHO has prepared some comments to CMS but needs your help to advocate for the best outcome for your health department."

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