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Washington Debrief: Federal Policy Committee Mulls Stage 3 Comments

February 11, 2013
by Jeff Smith, Assistant Director of Advocacy at CHIME
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Jeff Smith, Assistant Director of Advocacy at CHIME

Federal Policy Committee Ponders Stage 3 Strategic Direction The federal Health IT Policy Committee met for their monthly meeting this past week in Washington and Meaningful Use Stage 3 was back on the agenda. In under a month, ONC staff culled through more than 500 comments submitted to the Policy Committee that underscored concerns regarding the timing of Stage 3, the growing list of competing priorities for providers and a feeling that more interoperability limitations needed to be addressed.  After walking though comment overviews on all the measures and objectives, quality measurement questions and privacy / security questions, the Policy Committee took a step back to think more broadly about how Stage 3 could be approached.  A host of strategic suggestions were made, including comments that Stage 3 (1) needs to be more flexible in determining how health outcomes are improved; (2) should look to enable innovation; and (3) that maybe standards and certification timelines could be separated from provider timelines.  National Coordinator, Farzad Mostashari, M.D., wondered if incentives aren’t the best way to drive change, perhaps a star-rating for Meaningful Use could be developed that used a regulatory floor, but then created competition among peer providers to achieve greater levels of Health IT-enabled care delivery.

In providing the Health IT Standard Committee’s view, chair John Halamka said the main concern was that much more work had to be done to develop mature standards and implementation guides.  He said standards and interoperability for many functionalities and clinical procedures are still catching up to aspirations.

In related news, Policy Committee chair Paul Tang said that a report based on hearings held last week on barriers to health information exchange would be produced in March and that another hearing was planned for next week to look at issues surrounding clinical documentation.

CMS Looks to Align PQRS, Meaningful Use and Several Non-Federal CQM Programs The Centers for Medicare & Medicaid Services (CMS) is looking for information on how physicians and other eligible professionals might use clinical quality measures reported to non-federal programs to satisfy reporting requirements in the Physician Quality Reporting System and Electronic Health Record Incentive Program.  CMS is hoping that stakeholders can provide information on how data reported to the American Board of Medical Specialties, clinical data registries, regional health care quality organizations and other non-federal reporting programs may be similar, different or duplicate reporting requirements for clinical quality measures in the federal programs. The request for information will be open for public comment until April 8.

CHIME’s Policy Steering Committee is currently looking at the RFI and will be issuing a response to CMS in the coming weeks.  Stay tuned!

AHRQ Releases Updated Guidance on Children’s EHR Format The Agency for Healthcare Research and Quality (AHRQ) has officially outlined a redesign for pediatric EHRs, calling on vendors to improve functionality and customization features.  To address these needs, the Format includes a minimum set of data elements and applicable data standards that can be used as a starting point or checklist for EHR developers seeking to create a product that can capture the types of health care components most relevant for children. The child-specific data elements and functionality recommendations are sorted into various topic areas, including:

1.    Prenatal and newborn screening tests

2.    Immunizations

3.    Growth data

4.    Information for children with special health care needs

5.    Well child/preventive care

The project was developed by a host of organizations, including the University of Maryland’s Center for Health Information & Decision Support and will be piloted in two states – Pennsylvania and North Carolina – to use in their CHIPRA programs.