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Exclusive Interview: ONC’s Judy Murphy Talks about Meaningful Use Stages 2 and 3—and the Power of the Patient

March 26, 2013
by Mark Hagland
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ONC’s Deputy National Coordinator for Programs & Policy shares her perspectives on meaningful use and more

Senior officials from the Centers for Medicare & Medicaid Services (CMS) and from the Office of the National Coordinator for Health IT (ONC) had a higher-profile presence at the HIMSS Conference this year (held last month at the Ernest N. Morial Convention Center in New Orleans) than ever before. Along with CMS Acting Administrator Marilyn Tavenner, R.N., and National Coordinator for Health IT Farzad Mostashari, M.D., Judy Murphy, R.N., Deputy National Coordinator for Programs & Policy at ONC, spoke to HIMSS13 attendees in a scheduled appearance, and also met with groups of attendees in a variety of settings. The appearances of all those federal healthcare officials reflected a more high-profile presence than in the past, along with important announcements, such as the release of a self-described “aggressive” agenda” for healthcare IT in 2013 on the part of CMS and ONC.

In the wake of HIMSS13, Murphy spoke with HCI Editor-in-Chief Mark Hagland regarding her perspectives on the HIMSS Conference, Stages 2 and 3 of meaningful use, and what she’s most passionate about these days in her work. Below are excerpts from that interview.

What was your experience of HIMSS this year?

We had a little debrief at ONC afterwards, and I think we were pretty much in consensus that it felt different. And the ‘different’ part of it was pretty much around the idea of ‘frenzy,’ both among providers and vendors in the past, whereas, this time, it felt more like a digging down into the practical elements; it was just different from the previous feeling. Perhaps it was a maturity, I guess, of the industry, and the lack, really, of panic, and concern over Stage 2. Very different from last year, even.

You all seemed to put forward a tone of confidence and engagement this year at HIMSS, while maintaining your clarity on the core requirements that the industry is facing. I know you probably won’t like the word “cheerleading,” but how about persuasion? It seems that now is definitely a time where everyone at ONC realizes that it’s important to provide encouragement for the industry to move forward.  Am I reading your tone correctly?

I think you’re reading the tone correctly; however, I would extend it a little bit. I think what I’m focused on, and I think it extends to David [Muntz, principal deputy national coordinator] and Farzad [Mostashari, M.D., national coordinator for health IT] in the same way, though we haven’t specifically had this conversation, and that is, making it real. I’ve lived it; and I think we can say, think of it this way, or build it that way. So the interoperability modules; the Steve Posnack videotape going through the numerators and denominators; we didn’t have those tools in Stage 1. For the longest time, the implementation workgroup was talking about harmonizing the criteria themselves with the standards. And that ended up being integrated into a grid that Steve Posnack and his team created. But we’re trying now to give everyone tools, as opposed to making every patient care organization figure it out for themselves. I don’t like that word ‘cheerleading’; but I do like the word ‘persuasion.’ So it’s persuasion, coupled with some very pragmatic tools and programs. That having been said, we’re in a different place than we were at the beginning of Stage 1.

Judy Murphy, R.N.

It seems that there’s just more acceptance overall that meaningful use is happening, and it’s time to get moving, too, right?

Yes. I remember people saying at the beginning of Stage 1, ‘They’re not really going to pay us.’ And I was like, really? And then hearing the delight in people’s voices when they did get paid. At Aurora [the Milwaukee-based Aurora Health Care, where Murphy worked from 1995 through 2011, most recently as vice president of EHR applications], I think it was after 30 days. Now, there were some issues with Medicaid, but certainly for the Medicare reimbursements, things moved quickly.

I’ve talked with some industry experts who were particularly intrigued at the requirement under Stage 2 for LOINC-based lab values, which was underscored in documents made available during the HIMSS Conference.

If we’re going to have interoperability, we need standards based on vocabulary, packaging, and transport. And LOINC is vocabulary-related, per labs. And if we’re going to finish our journey of interoperability here, it’s going to be particularly important that if you send something, it can populate the EHR. And the only way to do that is to know that a hemoglobin is a hemoglobin, and the only way to do that is via LOINC. That requirement wasn’t new as of HIMSS13, though.

I know; I guess sometimes you do things at ONC, and people don’t even realize it at first.

Yes, sometimes we shine a spotlight on something, and people realize for the first time that it’s in the mix. We had Sunquest Lab at Aurora, and we could have chosen to use LOINC, but we didn’t, because we had built our application when they didn’t have LOINC. Now it has to be LOINC.

Is there anything that you can hint about, regarding the Stage 3 requirements?