As industry comments on the meaningful use (MU) program Stage 2 modifications and Stage 3 final rules came pouring in this week, the most common denominator amongst health IT stakeholders was that the requirements embedded inside the program offer providers very little flexibility. Healthcare groups such as the College of Healthcare Information Management Executives (CHIME), the American Hospital Association and the Healthcare Information and Management System Society (HIMSS), to name just a few, all asked the Centers for Medicare and Medicaid Services (CMS)to simplify and reduce the complexity of the program through a variety of different ways, some of which include: starting Stage 3 no earlier than 2019 and only after 75 percent of all eligible providers have met Stage 2; creating a 90-day reporting period for every year of the program, including the first year at Stage 3; and creating parity for both eligible providers (EPs) and eligible hospitals (EHs) by removing the existing pass/fail approach for meaningful use.
On the contrary, the Consumer Partnership for eHealth (CPeH), a Washington, D.C.-based patient advocacy group led by the National Partnership for Women & Families, recently released comments of their own on the final rules that sing a different tune. CPeH includes members from nearly 50 consumer, patient, and labor organizations working on both the national and local levels, and according to its officials, remains the only coalition comprised solely of consumer and patient advocates. Regarding CPeH’s meaningful use final rule comments, also signed by 24 other consumer and health organizations, the association has taken the opposite stance of many others, showing dissatisfaction with flexibilities allowed by CMS and giving support in some of the areas where the feds have stood their ground. Indeed, while many providers want to make significant changes to the program, CPeH argues that the current structure should be maintained.
While the Partnership doesn’t include providers themselves, Mark Savage, director of health information technology policy and programs for CPeH, says that they are in regular conversations with organizations such as AHA, the American Medication Association (AMA), and other physician-based groups. “We want physician perspectives,” Savage says. “In turn, they will sometimes try to persuade us to take different positions. It’s important for us to hear what they have to say, though. We have long-term working relationships with these provider groups,” he says. Savage recently spoke with HCI Managing Editor Rajiv Leventhal on the comments his organization made regarding the meaningful use final rules and why CPeH’s thoughts on the program are so different from many other health IT groups’ perspectives. Below are excerpts of that interview.
Many providers in the trenches say that the patient access requirements in MU are too reliant on factors outside clinicians’ control. What is your take on this?
The patient engagement measures that have been listed in our letters [to CMS] are about online access and secure messaging. Should patients be able to have online access to the information about them in the doctor’s record? It’s the same thing that’s important is in banking, voting, education, and shopping. It’s not any different in health.
With secure messaging, we’re talking about the ability to have two-way communication with your doctor whether it’s about convenient things such as lab tests or more fundamental things such as, Am I getting sick? Both of those, we say, and I think doctors would agree, are important things to be able to do. We did a survey last year that found that the more frequently people accessed their information, the more motivated they were to improve their health. This isn’t surprising when you think about it. This is what doctors and patients want, and it’s supposed to help reduce our 20 percent spend on GDP.
But are the thresholds for these measures too reliant on patients rather than physicians themselves?
[Note: In 2015 and 2016, CMS requires at least one patient to view, download, or transmit (VDT) his or her health data. This threshold increases to 5 percent in 2017, and 10 percent for Stage 3.]
It’s a partnership. Physicians may not be able to control 100 percent of what happens because it’s a partnership, meaning that it’s about the patients too. But doctors are certainly influential. If they explain why online access is available, and explain where you go to do it and why it’s important, that’s being influential. Doctors are among the most trusted people for patients, we know that. It’s an opportunity to help patients help doctors get them well. It’s a win-win situation.