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Washington Debrief: Is Meaningful Use in Danger?

September 8, 2014
by Jeff Smith, Vice President of Public Policy at CHIME
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Jeff Smith, Vice President of Public Policy at CHIME

Top News

New MU Rule Receives More Attention

Key Takeaway: More groups weighed-in on the new meaningful use (MU) rule, allowing providers to meet MU through alternative pathways in 2014. Concerns mount over full-year EHR reporting period coming Oct. 1, 2014.

Why it Matters: Health IT executives must quickly understand what options pertain to them in 2014. Regardless of which new pathways is taken, most hospitals are expected to have 2014 Edition EHRs implemented and configured to Stage 2 measures by Oct. 1, 2014 – the beginning of Fiscal Year 2015.

In the week following publication of a final MU Modifications rule, stakeholders across the country lent their voice to a growing chorus of disenchantment over the 2015 EHR reporting period. Executives from the American Hospital Association (AHA) to the AMA (American Medical Association (AMA), CHIME to MGMA (Medical Group Management Association (MGMA) and individual CIOs expressed thanks for the flexibility, but worried it would not be enough.  Several media outlets reported reactions that focused on the limited time providers have to take advantage of new flexibilities and they questioned whether hospitals, especially, would be able to take advantage of flexibilities and keep pace with 2015 reporting requirements. It is unclear what, if any, means of relief might be made available to providers who are not Stage 2 ready Oct. 1, 2014.

Stakeholders also learned that proposed rules for Stage 3 Meaningful Use can be expected sooner rather than later.  During remarks in Washington last week, National Coordinator Karen DeSalvo, M.D. said her office and Centers for Medicare and Medicaid Services (CMS_ officials would look for feedback on the next iteration of MU “sometime this winter.”


CMS to Health IT Policy Committee (HITPC): Meaningful Use Was in Danger

Key Takeaway: CMS officials reported last week that some 30 percent of providers (over 480,000 providers) may have dropped out of Meaningful Use in 2014 if the Stage 1 and Stage 2 criteria for 2014 were not changed.

Why It Matters: CMS and ONC have come to realize some of the readiness issues that could lead to patient safety issues resulting from the swift Meaningful Use timelines. This understanding comes from over a year’s worth of advocacy from hospital and provider groups, but CHIME thinks MU may still be in danger due to the 365-day reporting requirements in 2015.

2014 attestation numbers reported at the HIT Policy Committee meeting: 3,152 providers have attested to MU Stage 2 and 4,872 providers have attested to MU Stage 1 out of over 480,000 providers across the country. Meanwhile, 143 hospitals have attested to MU Stage 2 and less than 300 have attested to MU Stage 1 out of over 5,000 hospitals across the country. A lot of work must be done to meet the same rates as 2013: 290,307 providers and 4,007 hospitals attested to Stage 1.

New CTO, Deputy CTO Announced; Senior Counselor at HHS brings Health IT Experience

Key Takeaway: This week the Administration named Megan Smith, a senior Google executive, as their choice to replace Todd Park as the nation’s Chief Technology Officer. And Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced the promotion of Andrea Palm, a former Clinton staffer known for crafting health IT legislation, to the position of Senior Counselor.

Why It Matters: Looking to advance an agenda focused on the development of cutting-edge technology and innovation, and working to distance themselves from the woes of, the administration announced two well-respected Silicon Valley experts to join the Administration as CTO and Deputy CTO.

Coming from Google, Smith will bring valuable perspective on advancing innovation. As the nation’s CTO, Smith will guide the Administration's information-technology policy and initiatives, with the intention of advancing information and communications technologies across every sector of the economy to enhance the population’s well-being.The Administration also announced the addition of a Deputy Chief Technology Officer, Alex Macgillivray, formerly the top lawyer at Twitter. Macgillivray is privacy expert who led Twitter’s fights against government requests to access user data. The White House stated the new Deputy CTO will focus will be on policy matters, ranging widely from intellectual property to the complexity big data and privacy rights.

At HHS, the addition of Andrea Palm to list of the Secretary’s senior advisors moves someone with extensive health IT policy experience among the chief influencers HHS. Palm’s experience with health IT dates back to her position as a Senior Health Policy Advisor to then-Sen. Hillary Clinton, where she worked on health IT and biosimillars legislation. Prior to joining HHS as their Chief of Staff, Ms. Palm served on the White House Domestic Policy Council.


Congressional Briefing: From Point A to Point B: A View from Government and Industry Stakeholders on the Path towards Health IT Interoperability