EHR Certification Shortcomings Get Spotlight during June HITPC Meeting
Key Takeaway: The Health IT Policy Committee conducted its June meeting this past week; members received the latest Meaningful Use numbers and discussed proposals to amend ONC’s (Office of the National Coordinator) Certification Program.
Why it Matters: Discussions about how to amend a lynchpin of federal health IT policymaking – ONC’s Certification Program – continue in earnest. With a backdrop of low numbers of MU attestations, patient safety concerns and ongoing interoperability challenges, this may prove to be a timely opportunity to reassess how health IT products are certified.
In what turned out to be a slightly contentious meeting of the Health IT Policy Committee, officials learned that fewer than 10 hospitals had met enough objectives to qualify for Meaningful Use Stage 2 through June 1, and a key member of the committee called on ONC to suspend its Certification Program. New data released by CMS indicated that only eight hospitals, out of a scheduled 2000 hospitals, had managed to meet the requirements of Stage 2 Meaningful Use in 2014. Such numbers are not surprising and lend credence to the rationale for a recent NPRM to provide new pathways to meet MU this year. (Click here for access to an archived CHIME briefing on the proposed changes to MU, and click here for presentation slides.) The next mile marker for Stage 2 performance will come next month, as the third quarter of federal fiscal year 2014 comes to a close and the last reporting period for eligible hospitals and critical access hospitals begins.
The committee also heard a report detailing a recent ONC hearing on certification. The hearing included members of numerous stakeholder organizations, including CHIME members Cletis Earle (CIO, St. Luke’s Cornwall) and Colin Banas (CMIO, Virginia Commonwealth University Health System), and testimony produced several shared concerns, including:
- Insufficient time for product development and testing
- Immature testing tools and protocols
- Inconsistent application of certification criteria among testing labs, certification bodies and auditors
These complaints led to two recommendations: the formation of a “kaizen” to study end-to-end certification processes and establish a certification “roadmap and timelines;” and a commitment to limit the scope of future certification efforts to “interoperability, clinical quality measures and privacy and security.” Paul Egerman, a long-time committee member and software entrepreneur, called for the suspension of the certification program. ONC chief Karen DeSalvo was quick to dismiss the idea, but acknowledged that the program needs to be modified. While it is unlikely that ONC will halt its certification program, the convergence of several factors could give the ONC the perfect window to reconsider the parameters of its certification program. Meaningful Use Stage 3 policies are being drafted now; ONC has broad aspirations to lead health IT patient safety efforts, and a handful of wide-ranging reports have identified interoperability as a major challenge. Certification touches all these issues and could hold great promise for their eventual resolution.
Senators Request Input on Health Data Transparency, Availability
Key Takeaway: Senate Finance Committee Members, lead by Chairman Wyden (D-OR) and Sen. Charles Grassley (R-IA), have released a letter to healthcare stakeholders requesting feedback on how to increase data transparency in meaningful ways, not just releasing data for the sake of releasing it.
Why It Matters: Healthcare reform continues to be a high priority in Washington. With this letter to healthcare stakeholders, Senate Finance is asking for input on what data could best empower patients, and improve care quality and population health.
CHIME received a message directly from Senate Finance staff asking for input. All interested stakeholders are welcome to respond as payers, patients, developers, researchers and public health experts to describe potential benefits from increased access to health data. Specific questions include:
- What data sources should be made more broadly available?
- How, in what form, and for what purposes should this data be conveyed?
- What reforms would help reduce the unnecessary fragmentation of healthcare data? What reforms would improve the accessibility and usability of healthcare data for consumers, payers, and providers?
- What barriers stand in the way of stakeholders using existing data sources more effectively, and what reforms should be made to overcome these barriers?
Senate Finance requests that responses be sent to [email protected] by August 12, 2014. (All comments will be considered part of public record.)
CHIME Holds Briefing on New MU Options in 2014
Last week, CHIME held a Public Policy briefing on new Meaningful Use pathways being proposed by CMS and ONC. A proposed rule change would give providers new pathways to meet Meaningful Use in 2014, depending on what Stage they were meant to meet this year and what technology they have implemented. An archive of the presentation, including Q&A, can be found here; and a copy of the presentation slides can be downloaded here. Additionally, CHIME staff was able to get clarification on the following questions posed during the presentation:
Q: Can EPs using a common EHR choose different options in 2014 (e.g. some EPs do Stage 2, while others choose 2014 Stage 1)?
A: As proposed, this is possible, as long as the EPs have separate registrations, NPIs CCNs, etc. for the program in general.
Q: If someone chooses to run a retrospective report, say during Q1 using 2013 Edition CEHRT to meet 2013 Stage 1 objectives, how could a provider approach the security risk assessment requirement?
A: The security risk assessment objective must be met within the reporting year for 2014. The rule says reporting period, but that is an overall statement and is not reflective of the “abnormal” reporting periods in 2014.
Q: Can CQMs be submitted to CMS via manual input rather than submitted electronically if the provider is using 2014 Edition CEHRT to meet 2014 Edition Stage 1 or Stage 2 objectives?
A: Yes, EHs and EPs have the ability to attest manually or “eReport” via IQR / PQRS per info on this page.
Government’s Role in Regulating Health IT: A View from FDA and ONC
During a webinar to be held at 2 p.m. ET June 18, CHIME members will have the opportunity to hear from and dialogue with FDA and ONC officials regarding their proposed plans to protect patient safety and increase usage of health IT to lower costs and provide better quality care. Click here to register for this timely briefing now!
