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Washington Debrief: Meaningful Use Stage 3 Response, ONC Town Hall Held

January 22, 2013
by Jeff Smith, Assistant Director of Advocacy at CHIME
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Jeff Smith, Assistant Director of Advocacy at CHIME

CHIME Submits Response to Preliminary Stage 3 Meaningful Use Measures  The Federal Health IT Policy Committee has been working for months on developing measures and objectives for Stage 3 Meaningful Use and in November they shared those thoughts with the wider health IT community of stakeholders for input. Recently, CHIME submitted a response to the HIT Policy Committee, urging caution about the assumed pace and practicality of those Stage 3 measures.  CHIME urged the federal advisory committee to recommend thorough evaluations of what has been accomplished thus far in order to place realistic measures and objectives for the nation’s hospitals in Stage 3.  “We see no value in setting unrealistic performance thresholds or expectations before current evaluations of what we have accomplished have been undertaken,” CHIME said. “[E]very desirable EHR-related objective cannot feasibly be met by 2016, nor do we see any value in attempting the rushed adoption of various EHR uses by that time. Instead, verifiable and continuous progress should be the goal.”  In several of the group’s responses to CQM questions, CHIME urged regulators to keep a handful of fundamental tenets in mind: future measure sets should always tie back to care delivery quality and clinical efficacy; they should be expansive enough to allow clinical flexibility based on population characteristics; and regulators across federal, state, local and private sector reporting organizations should convene to understand what collection and reporting requirements will allow for optimal care quality improvement. 

HIEs, Providers and Certification Bodies: We Need More Standards to Boost Health Info Exchange The Office of the National Coordinator held a Town Hall listening session this week to better understand what barriers to exchange are impacted by governance.  The session was attended by a mix of stakeholders including hospitals, physicians, HIEs, state government and vendors, among others. In opening comments made by Dr. Mostashari, he said that ONC was interested in learning what challenges of trust inhibit exchange and he outlined several non-regulatory steps the agency was taking to better understand the challenge.

The Town Hall stems from a Request for Information released by ONC in the spring 2012 on health information exchange governance.  CHIME responded and joined a chorus of stakeholders, urging ONC to take a step back from implementing a far-reaching governance framework.  Instead, CHIME suggested that more information be sought to identify the true barriers to exchange – beyond those of trust.  CHIME commented, “The RFI appears to assume that trust is the principal barrier to information exchange at this time. However, CHIME believes that interoperability, patient data-matching, the lack of consistent patient consent practices at the national level (with respect to the exchange and disclosure of protected health information), and a sustainable business model for health information exchange are actually greater challenges.”

During the Town Hall Thursday, stakeholders from HIEs, providers and certification bodies all underscored the need of more granular standards.  “In our view, the way to ensure trust is to ensure trust through the use of standards,” said Jeff Smith, Assistant Director of Public Policy for CHIME. “The issue is that exchange standards are still not clear, the technical capabilities of EHRs to transmit data are not uniform, and federal leadership is needed.”

Other stakeholders agreed as evidenced through a poll of attendees, finding that 78 percent thought the focus on HIE governance should focus on standards and interoperability.

A look at the 113thOn January 3, many freshmen members of Congress were sworn in to the 113th Congress.  With an election and the arrival of new members, House and Senate leadership change as well.  Here’s a look at the new (and returning) leadership of a few important healthcare committees. 

House: Rep. Kevin Brady (R-TX) will lead the House Ways and Means Health Subcommittee; Rep. Jack Kingston (R-GA) will be the chairman of the Labor, HHS and Education Subcommittee; and Rep. Tim Murphy, (R-PA), a psychologist and the new chair of the House Energy and Commerce oversight subcommittee.

Senate: Sen. Bill Nelson (D-FL) took over the chairmanship of the Special Committee on Aging.

Those keeping their posts:

House: Rep. Joe Pitts (R-PA) will stay as chairman of the Energy and Commerce Health Subcommittee and Rep. Frank Pallone Jr. (D-NJ) will stay on as ranking Democratic member of the subcommittee.

Senate: Sen. Max Baucus (D-MT) will remain at the head of the powerful Senate Finance Committee; Sen. Tom Harkin (D-IA) stayed as chairman of the Appropriates Subcommittee Health, Education, Labor and Pensions Committee and in that same committee, Bernard Sanders (I-VT)will stay the chairman of the Subcommittee on Primary Health and Aging.