Washington Debrief: ONC Highlights Interoperability in Annual Report

ONC highlights Interoperability in Annual Report to Congress

Key Takeaways: The Office of the National Coordinator (ONC) filed their annual report to Congress this week, touting an enhanced focus on interoperability, citing the 10-year road map currently under development.

Why It Matters: This report is an annual update to Congress on the state of health IT adoption and use. The industry has made tremendous strides in the last four years, and clearly the conversation has shifted beyond adoption. It remains unknown how congressional overseers will view this report, and it will likely garner mixed reactions. Depending how the next few weeks progress, it may be an opportunity to have an open dialogue between the agency and congressional officials.

Mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act, ONC must submit an annual report to Congress on the adoption of a nationwide system for electronic use and exchange of health information. The report must include the barriers inhibiting health information exchange and make recommendations to enhance the nationwide system for electronic health records envisioned by the legislation. In evaluating barriers, ONC echoed its recent statements pointing to the lack of uniform standards as a barrier to the nationwide system, saying, “Electronic health information is not yet sufficiently standardized to allow seamless interoperability, as it is still inconsistently expressed through technical and medical vocabulary, structure, and format, thereby limiting the potential uses of the information to improve health and care.”

Noticeably absent was any comment on attestation rates for Stage 2 of the Meaningful Use Program. However, the report states that Stage 2 of the Electronic Health Record (EHR) Incentive Programs should serve as a catalyst for promoting the exchange of clinical information across organizational boundaries and EHR developer platforms, citing the need to provide a summary of care record for transitions of care.

CMS Extends Hardship Exception Deadline to Avoid 2015 Penalties

Key Takeaway: The Centers for Medicare and Medicaid Services (CMS) sent out a statement last week announcing its intent to reopen the hardship exception application process to help providers and hospitals avoid payment adjustments in 2015.

Why It Matters: Originally, hospitals had to apply for a hardship exception by April 1, 2014, and providers by July 1, 2014, to receive a hardship exception to avoid penalties in 2015. The announcement made last week will reopen the application period for both EPs and EHs until Nov. 30, 2014.

A few weeks ago, CMS announced it has received 44,000 hardship exception applications, an indication that many providers were having trouble meeting Meaningful Use requirements this year. It is unclear how many exceptions CMS has granted. According to the CMS announcement, “This reopened hardship exception application submission period is for eligible professionals and eligible hospitals that:

• Have been unable to fully implement 2014 Edition CEHRT due to delays in 2014 Edition CEHRT availability; and
• Eligible professionals who were unable to attest by October 1, 2014, and eligible hospitals that were unable to attest by July 1, 2014, using the flexibility options provided in the CMS 2014 CEHRT Flexibility Rule.”

For more information, go to the payment adjustment and hardship exception.

ONC Releases Plans for Health IT Safety Center

Key Takeaway: ONC has awarded a contract to RTI International to help federal agencies build a roadmap for the Health IT Safety Center proposed by the Food and Drug Administration Safety and Innovation Act (FDASIA) Report. According to an RTI International statement (http://www.rti.org/newsroom/news.cfm?obj=FCC8767E-C2DA-EB8B-AD7E2F778E6CB91A), “The road map will aim to define the focus, functions, governance and value of a new national health IT safety center.”

Why It Matters: ONC will be leading the development of the Health IT Safety Center, with input from other agencies and the private sector. It is not yet clear which pieces of the Safety Center will be prioritized, but provider organizations could see increased reporting requirements through Medicare and Medicaid in coming months. It will be important for providers to be engaged with this process to ensure that reporting requirements add value and don’t further burden the delivery of safer care.

ONC announced last week that it would be using RTI International to create a task force composed of both public and private organizations to build the Health IT Safety Center roadmap. According to the FDASIA Report (http://www.fda.gov/downloads/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDRH/CDRHReports/UCM391521.pdf), “The Health IT Safety Center would serve as a trusted convener of health IT stakeholders in order to focus on activities that promote health IT as an integral part of patient safety with the ultimate goal of assisting in the creation of a sustainable, integrated health IT learning system that avoids regulatory duplication and leverages and complements existing and ongoing efforts.”

Earlier this year, a few House Republicans questioned ONC’s authority to create a Health IT Safety Center, and ONC defended itself, saying the safety center would not have the authority to regulate health IT,” but rather, “it would facilitate the creation of a health IT learning system.”

CHIME LEAD Forum Highlights Key Cyber Security Threats Facing the Industry

Key Takeaways: The healthcare industry faces complex threats from both internal and external sources, which may even include clinicians and administrative staff in hospitals and medical groups. Meanwhile, cyber criminals continue to target health data stored electronically.

What it Matters: At the October 6 Health Information Executive’s Guide to Cyber Security, CHIME held one of its regional LEAD Forums, in collaboration with the Institute for Health Technology Transformation (iHT2), to convene cyber security experts to discuss the evolving nature of security and need for continued preparedness in a time of increasing data insecurity. Along with other regional events, CHIME is working to raise awareness of healthcare security and promote the role of senior IT security leaders within healthcare.

During discussions at last week’s event, it was estimated that only about 60 percent of hospitals and health systems have CISOs, and of those, many are new to information security. For January through April 2014, the Office of Civil Rights tallied 17 breaches of 500 or more patient records, up from only five during the same period in 2013. These breaches are causing the cost of data security to rise, which is compounded by the increasing number of lawsuits filed against patient care organizations.

Experts surmised that new federal mandates that cover accounting for disclosure and data security regulations are unavoidable, but will likely not come until after this administration has left office, even pointing as far ahead as 2017.

Those who are interested in learning more about what colleagues are doing to prevent cyber attacks, and discuss the challenges, latest trends in cyber security can join CHIME for our next regional LEAD Forum in on Dec. 9, 2014 in Houston, TX. Save the Date!

Edited for style by Gabriel Perna