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D.C. Report: Early Implementation, Certification and Privacy, Maryland HIE

July 28, 2010
by Sharon Canner
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Hearing on Meaningful Use Examines Early Implementation Steps. Although the MU Final Rule is a little over a week old, the sparring has already begun as demonstrated at a hearing of the House Ways and Means Health Subcommittee this week. Subcommittee Chair Pete Stark (CA-D-13) set a positive tone for the hearing by noting that,” Widespread adoption of health IT has enormous potential to improve health quality, reduce adverse outcomes and facilitate communication with patients, while reducing overall health care costs. We are eager to hear from the Administration and stakeholders about how the program is progressing.”

Testifying for the minority, Jonathan Hare, Chairman and Founder, Resilient Networks Systems, was critical of the MU Final Rule on exchanging health information. “Unfortunately,” said Hare, “the measure specified in the final rule for 2011 and 2012 is to ‘perform at least one test of the EHR’s capacity to electronically exchange information.’ There is no requirement to implement authentication, consent, authorization, disclosure management or any other services specifically mentioned in the HITECH Act that are necessary to genuinely enable secure electronic exchange of information.”

Republican members of the committee observed that the final rule will be ineffective in promoting EHR adoption, and questioned whether this was a good use of taxpayer money. Rep. Wally Herger (R-CA) criticized the rule by saying that patient care would not improve by “watering down” the final rule. However, Dr. David Blumenthal testifying on behalf of the Administration defended the rule, saying that the stage 2 requirements will require providers to meet higher standards by 2013. He also stated that the requirements were more achievable with the current infrastructure.

Subcommittee chairman Peter Stark (D-CA) disagreed with his Republican colleagues by calling the final rule “responsible” and “realistic.” Tony Trenkle stated that the final rule was drafted after an exhaustive consideration of stakeholder input, will ensure adoption and meaningful use of EHRs. Moreover, Trenkle also told committee members that Congress would need to change the definition of a hospital for reimbursement purposes.

In its next step, the House Energy and Commerce Health Subcommittee scheduled to examine Meaningful Use at a hearing on July 27.

HIT Policy Committee Focuses on Certification and Privacy. With some reluctance, the ONC Health IT Policy Committee unanimously approved the recommendations of its privacy and security tiger team during their meeting on Wednesday, July 21, 2010. The first set of recommendations was approved with the condition that the committee vote on the complete package in September. Included was a recommendation that providers accept responsibility for their patient’s privacy by determining what information should be available to the health information exchange or IT vendors. However, the committee was divided over whether patients should be given the choice of opting in or out of the exchange. Members recognize that reaching a consensus on this issue was not likely in the near future and have called for a full public debate on this issue.

On the topic of certification, the ONC expects that multiple organizations will test EHR products, leading to increased competition during the certification process. It is also expected to speed up the process for providers to certify and test products in order to meet the 2011 deadlines set by the ONC. Director Dr. Blumenthal announced that about sixteen organizations have completed applications and the ONC will have thirty days to approve these applications. Once these organizations are authorized, the ONC expects testing of EHR products to begin by the end of this summer. Click here for the July 21 meeting materials and watch for a continued dialog on privacy and security issues when the Standards Committee holds its July 28 monthly meeting.

StateWatch. As more focus shifts to state implementation, CHME will report developments of HIE/HIT happenings around the nation.

Maryland-State HIE to Launch in September. Five hospitals in Maryland’s Montgomery County- Holy Cross Hospital, Montgomery General Hospital, Shady Grove Adventist Hospital, Suburban Hospital and Washington Adventist Hospital- will be part of the state HIE, which is slated to begin this September. The State HIE is being developed by Chesapeake Regional Information System for our Patients (CRISP), which has received $15 million in grant money. The remaining hospitals in the state will join the HIE by 2012. Governor O’Malley wants to make sure this ambitious goal is achieved. A roundtable discussion was held by the governor with industry leaders and experts to discuss healthcare technology and health reform. Maryland is one of three states to have its plan approved by the ONC and the launch of the exchange is sure to make it a leader in health IT adoption.