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Washington Debrief: Discussions Swirl on Best Route to Digitize Post-Acute Providers

July 1, 2014
by Jeff Smith, Senior Director of Federal Affairs
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Jeff Smith, Senior Director of Federal Affairs

Quality Standards Seen as Opportunity to Wire LTPAC Providers

Key Takeaway: EHR standards for long-term and post-acute care settings will be addressed in future work, CMS and ONC officials vow. Federal officials hope that more standards specific to LTPAC quality measures will increase the value proposition for adopting EHRs in this segment of the care continuum, which currently is excluded from Meaningful Use incentives.

Why It Matters: Federal policies will continue to push for more information sharing among ambulatory, inpatient and LTPAC providers. If post-acute care settings continue to lag in EHR adoption, ambulatory and inpatient providers will end up being penalized by federal policies.

During an annual meeting of the Long-Term and Post-Acute Care Health Information Technology Summit, officials from CMS and ONC said standardized data elements are needed in EHRs specific to long-term and post-acute care providers. “The biggest thing we want to focus on is standards,” David R. Hunt, a medical director for the ONC, told reporters. “As we build standards around hospitals and ambulatory offices, we also want to make sure those standards are compatible with hospices and with nursing facilities.” Federal officials believe that by developing standards – especially around clinical quality measures – LTPAC providers will see the value of adopting EHRs.

According to a recent survey by the Center for Aging Services Technologies, fewer than 30 percent of all post-acute care providers have adopted an EHR system; by contrast, nearly 60 percent of eligible professionals and more than 80 percent of eligible hospitals have adopted EHRs. The effect of this dynamic can be seen in the low numbers of EPs and EHs that have met Stage 2 Meaningful Use requirements – one of which calls for referral partners (including LTPAC providers) to accept electronic summaries of care records during a transition of care. If this segment of the care continuum had higher rates of EHR adoption, many of the EPs and EHs struggling to meet transitions of care requirements would have more opportunities to send electronic summary of care records, and Stage 2 performance may not be so poor.

House Leaders Hold “21st Century Cures Roundtable: Digital Health Care”

Key Takeaway: The government is stepping up their approach to healthcare and health information technology with a series of roundtables and commenting opportunities to get feedback on digital health innovation and the current regulatory landscape.

Why it Matters: Last week, the House Energy and Commerce committee held a roundtable called “21st Century Cures Roundtable: Digital Health Care,” where they brought together entrepreneurs, health IT developers, a representative from the FDA, medical research organizations, a large health system, and others to discuss the next steps for healthcare innovation.

This effort started in May, when the House Energy and Commerce put together the “21st Century Cures: Call to Action.” Since the release of their call to action, the committee has asked for consumer feedback on their experiences in the healthcare system, and industry feedback on the 2012 PCAST Report and how “new technology and data can shift our health care system from a reactive one defined largely by its silos into a predictive and integrated care continuum.

The main themes of the roundtable included data accuracy, interoperability between systems, patient safety, patient engagement, ownership of data, and smart regulation. The ICD-10 delay is a prime example of a deadline that has changed several times because of regulatory and legislative intervention. With such changes, how are healthcare providers and systems supposed to plan, invest and train for a transition without a firm deadline that they can trust? Similar to this effort, the Senate Finance Committee asked health IT stakeholders to submit comments on digital health innovation a few weeks ago. The committee hopes to have legislation ready for consideration early next year.

CHIME Supports New Pathways for Meaningful Use in 2014

In comments submitted Friday, June 27, on proposed “Modifications to the Medicare and Medicaid Electronic Health Record Incentive Programs for 2014,” CHIME offered general support of program changes, but requested additional revisions and clarifications to maintain momentum of the federal initiative. Comments from the professional association of healthcare CIOs and IT leaders said additional flexibility is needed because changes proposed for the Meaningful Use incentive program were only first released in late May, limiting the amount of time providers have to react to changes. “CHIME supports the new pathways as defined in the proposed rule,” the letter read. “We believe these options will provide needed flexibility for EHR optimization, encourage continued participation in the program and help maintain the upward trajectory of EHR adoption in the US.” One of CHIME’s primary requests is that the Centers for Medicare & Medicaid Services allow providers to choose any three-month quarter for an EHR reporting period in the next federal fiscal year or calendar year to qualify for Meaningful Use in 2015. As currently structured, the program requires providers to report a full year of data to qualify for incentives.

“We believe this change will have a dramatically positive effect on program participation and policy outcomes sought in 2015,” CHIME’s comments noted. “The additional time afforded by this modification would help hundreds of thousands of providers meet Stage 2 requirements in an effective and safe manner.”