D.C Report: HIT Standards Committee Looks at Stage 2 Recommendations, Deficit Deals Loom

HIT Standards Committee Looks at Stage 2 Recommendations, Receives Updates from Summer Camp Power Teams
The Health IT Standards Committee (HITSC) held its monthly meeting this week in Washington. A series of recommendations were delivered from its various workgroups and power teams, including a review of the technical requirements of meaningful use Stage 2 recommendations adopted earlier this month by the Health IT Policy Committee (HITPC). Some of the more daunting standards that need to be addressed by the HITSC for Stage 2 include defining certification attributes for clinical decision support (CDS) and electronic medication administration records (eMAR). HITPC also sought an opinion on the best way hospital labs could provide structured electronic lab results—as adopted recommendations say to use “LOINC, where available.”

Updates were also delivered by HITSC’s Summer Camp power teams focused on issues related to patient matching (.ppt) and Nationwide Health Information Network (NwHIN) standards and protocols. Both of these power teams are in early stages of their work, with summaries due back to the HITSC in September. Finally, early results from an online survey distributed by the Implementation Workgroup, highlighting the number and types of comments received. CHIME submitted, along with five other organizations, a letter and slide deck, “Certification Experiences and Observations from the Field” to help address questions asked in the survey. The latter information was shared with the HITSC.

CMS Releases New MU FAQ, Updates Attestation Numbers
To help address some confusion surrounding a key measure of meaningful use, the Centers for Medicare & Medicaid Services (CMS) released a new FAQ this week focused on the capability to exchange key clinical information. Under this objective, providers have to (1) use certified EHR technology to generate a continuity of care document (CCD) / continuity of care record (CCR), and (2) electronically transmit the CCD / CCR. The new FAQ states that an eligible professional, eligible hospital, or critical access hospital “may use any means of electronic transmission according to any transport standard(s) (SMTP, FTP, REST, SOAP, etc.) regardless of whether it was included by an EHR technology developer as part of the certified EHR technology…” It emphasizes, however, that the use of USB, CD-ROM, or other physical media or electronic fax would not satisfy the measure of this objective.

Also this week, CMS updated totals for payments made through the EHR Incentive Payments Program. As of June 1, $75,856,912.84 has been paid through Medicare, $70 million of which went to eligible hospitals. So far CMS indicates that more than $190 million has been paid to providers through Medicare and Medicaid for investments in certified EHR technology.

Note: July 3 is the deadline for hospitals to begin their reporting for 2011 Attestation. After this date, hospitals can no longer attest in fiscal 2011.

Deficit Deals Loom as Context Shifts to Economic Recovery
This week was a frenetic one in ongoing deficit talks ahead of an August 2 deadline to raise the federal debt ceiling. A new report from the Congressional Budget Office highlighted entitlement spending and healthcare’s role in growing the national debt as a percentage of GDP. According to the report, national demographics in conjunction with rising healthcare costs would lead to a debt that is nearly 200 percent of GDP within 25 years, if current policies are sustained. “Without significant policy changes, an aging population and rising per capita healthcare costs will lead to surging federal debt,” the report (.pdf) said. But the CBO also warned that immediate federal spending cuts could hurt the fragile American economic recovery—a point that was echoed by Federal Reserve Chairman Ben Bernanke in a press briefing this week. Currently, Vice President Joe Biden is leading a series of negotiations that would reportedly trim $2 trillion from the debit over ten years—a number critics on both sides of the aisle argue is too small.

Also released this week was a report commissioned by a coalition of healthcare associations including the AHA and AMA finding that current proposals to limit spending in Medicare and Medicaid, “could force most hospitals into the red, physicians out of the Medicare program, 5.1 million people to lose their health insurance, and 1.3 million healthcare workers to lose their jobs.” The Lewin Group study (.pdf) looked specifically at the Commitment to American Prosperity Act (CAP) concluding that “legislation using across-the-board budget cuts to meet arbitrary federal spending caps can have extremely serious consequences for the most vulnerable members of our society.”