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Creating accountability is impossible until we transform the current volume-based system into one that pays providers based on outcomes (quality) and value (efficiency).Once a link has been made between compensation and results, provider accountability will grow.) – Physicians will not be required to include a cancer diagnosis on the electronic health records that all Americans are supposed to have by 2014 under the terms of the Democrats' 2009 economic stimulus law, according to the Office of the National Coordinator for Health Information Technology, a division of the Health and Human Services Department that is responsible for setting the rules for the EHRs.By contrast, HHS is mandating that all EHRs include a person’s Body Mass Index.To promote accountability, and build on existing medical practice patterns, Congress has taken an important step in the creation of Accountable Care Organizations (ACO) in health reform law.ACOs are one of the key efforts of the recent healthcare reform legislation that address the two greatest challenges facing U. health care: unsustainable escalation of costs that threaten the affordability of care and care that is fragmented, poorly coordinated with little accountability for the outcomes of care.The Office of the National Coordinator for Health IT (ONC) has funded several major initiatives to harmonize standards and create a certification process for EMRs so that different products can interoperate better and be easily and objectively compared. Department of Health and Human Services (HHS) recognized initial criteria for certification of ambulatory EHR systems as recommended by the Certification Commission for Healthcare Information Technology (CCHIT).This will enable decisionmakers to adopt EMRs more easily. The criteria were updated in 2010 These criteria will help reduce barriers for ambulatory providers to adopt EHR systems by ensuring confidence in purchased products.

The Rule does NOT require a doctor to include a cancer diagnosis, abortion or HIV/AIDS diagnosis in an EHR.

A leading oncologist and former chair of the EHR Working Group at the American Society of Clinical Oncology, however, told that HHS should "know better" than to say that a cancer diagnosis need not be included on a person's EHR and that it only "makes sense" for oncologists, who specialize in treating cancer patients, to include such a diagnosis in a person's federally mandated EHR. In response to CNSNews.com's written question, a spokesperson for HHS's Office of the National Coordinator for Health Information Technology, emailed this statement: “Providers will treat health information the same in the electronic world as they have in the paper world.

HHS made its statement that EHRs do not need to include whether a person has been diagnosed with cancer in a written answer to emailed in response to the following question: “Do doctors have to include pregnancies in electronic health records? They will record the information necessary to treat the patient in the electronic medical record.

CCHIT certified products also meet requirements set forth by HHS in final physician self-referral law and anti-kickback statute rules, providing access to external means of implementing EHR systems.

Federal initiatives are under way to drive adoption of interoperable EMRs, including funding of the Agency for Healthcare Research and Quality (AHRQ) Health IT portfolio.

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