NeoTool — Singular Focus, Healthcare Integrated

Posted in EHR, EMR

As noted in HIS-Talk and HANYS News, CMS released an advisory opinion that allows for hospitals to pay the cost of EMR interfaces without violating the Stark Law. Hospitals are restricted under the US law regarding compensation arrangements between physicians and hospitals. HANYS News wrote:

Specifically, a hospital system can pay for the creation of an electronic interface between unique electronic health record (EHR) systems of individual physician practices and the hospital network’s EHR system. The interface would allow physicians, from their practices, to order and communicate the results of tests and procedures performed.

The CMS news was delivered in “Advisory Opinion No. CMS-AO-2008-01″. There are many words used in the advisory; here is a quote that is the meat of the opinion:

The Requestor … owns and operates … hospitals … [and] contracted with a third-party … Vendor … to install a proprietary health care software information …System …, customized to the Requestor’s specific requirements, including a software interface engine that facilitates access by the custom Physician Practice Interface(s).

Pursuant to the contract between the Requestor and the Vendor, the Vendor provided software licenses to the Requestor that permit the Requestor and its controlled affiliates to use the System.

Currently, the medical staffs of Requestor’s … hospitals have the option to view laboratory reports for the Requestor’s patients over a protected internet connection to the System. The Proposed Arrangement would permit also the ordering or communicating of laboratory tests or procedures performed by the Requestor using the Physician Practice Interface(s).

Numerous physicians on the Requestor’s medical staffs have begun to purchase and use electronic health records (“EHR”) systems for their private practices. Requestor would like to integrate its System with individual information systems maintained by the Affiliated Physician Practices to promote the secure transfer of patient data between the parties. Integrating the System with each Affiliated Physician Practice requires the custom development of an interface that can extract data from the System and transfer it to the Affiliated Physician Practices’ EHR systems. The Requestor may need to develop several versions of the Physician Practice Interface to accommodate the various EHR systems. The Requestor would limit the functionality of the Physician Practice Interface to the ordering or communicating the results of laboratory tests or procedures furnished by the Requestor.

Under the Proposed Arrangement, the Vendor would develop, and the Requestor would pay the development cost of, a Physician Practice Interface customized to the Affiliated Physician Practice’s existing EHR software. … Physician Practice Interface would be used only to order or communicate the results of tests and procedures furnished by the Requestor and could not be used for any purpose other than the ordering or communicating of the results of tests or procedures furnished by the Requestor.

…

Therefore, we have determined that the Proposed Arrangement does not meet the definition of “compensation arrangement” for purposes of the statute’s prohibition on physician self-referral
…

Last 5 posts by Dave Shaver

• HL7 Working Group Meeting Includes Strong International Attendance - September 16th, 2008
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• Massachusetts Hospitals Must Have CPOE by 2012 and CCHIT-Certified EHRs by 2015 - August 13th, 2008
• HL7 Dates and Times - July 25th, 2008
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