Washington Debrief: Senate Funding Report Tells ONC to Focus on Interoperability

Senate Funding Report Tells ONC to Focus on Interoperability, End ‘Information Blocking’

Key Takeaway: The Senate Appropriations Committee released draft spending legislation and report language for the Department of Health and Human Services for Fiscal Year 2015, specifying funding priorities at the Office of the National Coordinator for Health IT (ONC), including information sharing and interoperability.

Why it Matters: In recent comments, CHIME asked ONC to reconsider the role and composition of its certification program to address patient safety risks and interoperability. The language in the report released by Senate Democrats accompanying the FY15 HHS funding bill reflects a similar frustration, one that previously had only been voiced by Senate Republicans, attacking the lack of interoperability in the health IT industry and the need to revisit the certification program.

Regarding “information blocking,” the Committee asked ONC to report on how many organizations are involved in the “information blocking problem.” The Committee suggested that ONC should use its authority to certify only those products that clearly meet current meaningful use program standards and also do not impede health information exchange. The report language calls on ONC to decertify products that proactively block the sharing of information and thus make this technology less valuable and more burdensome for eligible hospitals and eligible providers to use.

The appropriators also asked the Health IT Policy Committee to submit a report within a year of enactment of the legislation to the Senate Committees on Appropriations and Health, Education Labor and Pensions (HELP), detailing the challenges and barriers to interoperability. Lastly, the Committee asked for further information on the role of certification in advancing or hindering interoperability across various providers. The report language is not legally binding, but agencies generally follow the Committee’s recommendations. The Committee set ONC’s FY15 funding level at $61,474,000, an increase of about 2 percent from the $60,325,000 they received in 2014.

The current political climate suggests that it is unlikely any of the FY15 spending bills will advance before the November elections. Congressional leadership has stated an intention to pass a Continuing Resolution (CR) as a temporary spending measure to fund the government beyond Sept. 30, 2014.

Hearings Focus on Privacy Policy, Big Data in Healthcare

Key Takeaway: Lawmakers and regulators held hearings last week to better understand what barriers inhibit the flow of “big” health data for research and similar purposes.

Why it Matters: Increasingly, stakeholders are openly discussing the shortcomings of federal privacy laws and the patchwork of state laws that dictate when large amounts of health data can be used for research purposes. Continued pressure may force lawmakers to address gaps in divisive privacy policy.

Several stakeholders, including providers, researchers and technologists, have told policymakers in recent weeks that changes must be made to privacy laws to ensure that the benefits of big data are accrued in healthcare. During a pair of hearings – one held by the House Energy & Commerce Committee and the other by HHS’s Advisory Committee on Human Research Protections – policymakers were told current regulations make it difficult to utilize large amounts of health data to improve care. Clinical and research professionals said the lines between quality improvement efforts and health research are blurring and that consent laws are outdated. Testimony given during the Energy & Commerce hearing focused on the need to update and modify HIPAA’s authorization components, and amend federal “data use agreement” restrictions. Officials discussing the issue at the HHS advisory meeting focused on patient consent and what data uses should require patients to opt in vs. opt out of sharing their data.

It is not entirely clear how much additional pressure will be required for HHS and Congress to re-examine privacy laws, but the debate will likely continue well into the future.

ONC Seeks Input on Certification Test Methods

Key Takeaway: ONC’s Standards and Interoperability Framework has launched an Open Test Method Development Pilot Program to encourage stakeholder engagement in the health IT certification program.

Why it Matters: In recent comments to ONC, CHIME argued for improved testing, as part of certification, to ensure that certified EHR modules can interoperate with one another. This initiative will give participants a chance to improve the certification process by building tests based on input from technology developers and providers who use certified EHR technology.

The Open Test Method Development Pilot Program enables stakeholders to contribute their expertise on test methods, including test procedures, test data and test tools, that could be used by accredited testing laboratories for health IT testing. The pilot program is limited to two 2014 Edition EHR certification criteria, which eventually will be evaluated for feasibility, efficiency and scalability relative to future EHR editions. On Aug. 4, 2014, ONC will post the two certification criteria chosen for the open test method development pilot program. ONC hopes to complete the development of two test methods by Oct. 31, 2014.

To learn more about the Open Test Method Development Pilot Program, click here.

Lawmakers to Introduce Medicare Telehealth Expansion Bill

Key Takeaway: Two House lawmakers plan to introduce, the “Medicare Telehealth Parity Act of 2014” next week. If adopted, this bill would gradually increase telehealth coverage over four years.

Why It Matters: Five years after the passage of HITECH and billions of dollars of investment in electronic health records, lawmakers are feeling more pressure from the healthcare community to expand Medicare coverage for remote monitoring systems and telehealth visits, as part of continued efforts to reduce healthcare costs and improve outcomes.

In the midst of the House Energy and Commerce “21^st Century Cures” initiative, Reps. Glenn Thompson (R-PA) and Mike Thompson (D-CA) will file their own telehealth bill, the “Medicare Telehealth Parity Act of 2014,” next week. If adopted, this bill would gradually increase telehealth coverage over four years. Currently, Medicare only covers telehealth visits for “rural Health Professional Shortage Areas” as defined by the Health Resources and Services Administration (HRSA).

Six months after enactment of this bill, telehealth videoconferencing would be covered at any Federally Qualified Health Center, in any “Metropolitan Statistical Area with a population of fewer than 50,000 individuals,” and in “a walk-in retail health clinic that is located in a county within a Metropolitan Statistical Area with a population of fewer than 50,000 individuals.” In this time frame, the bill also calls for coverage of remote patient monitoring for chronic diseases like diabetes, congestive heart failure and other conditions. Two years after the adoption of the act, it expands telehealth coverage to teleconferencing for metropolitan counties with 50,000 to 100,000 people, and adds outpatient therapists to the list of telehealth providers. And finally, after four years, telehealth services would be covered at walk-in retail clinics in metropolitan areas with populations of more than 100,000. Overall, the bill hopes to lower cost by reducing admissions and readmissions. Action isn’t expected on this bill until 2015.

Call for Nominations: Federal Public Policy Award for CIO Leadership

This annual award recognizes leadership at the federal level for a range of activities:

• Demonstrated leadership at the federal level in educating policymakers on the value of health IT through congressional letters, congressional meetings and/or regulatory comments, among other things;
• Testifying before federal workgroups or a congressional committee;
• Visiting with your representative, senator or congressional staff in D.C. or in your district; or
• Providing your feedback on federal level initiatives through StateNet and myCHIME.

The award will be presented on Wednesday, September 17, during the NHIT Week Awards Reception in Washington, DC. A follow-up presentation will be made at the Fall Forum Awards Ceremony in October.

Deadline: Friday, Aug. 1, 2014. Apply or nominate (http://www.cio-chime.org/scholarshipandrecognition/FPP_leadershipaward.asp) someone today.

If you have questions, please contact Angela Morris.