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Washington Debrief: ONC Standards Group Begins New Pilot

July 23, 2013
by Jeff Smith, Director of Public Policy at CHIME
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Jeff Smith, Director of Public Policy at CHIME

Senators Query CMS, ONC on Health IT Progress; Officials Say Stay the Course

The Centers for Medicare & Medicaid Services and Office of the National Coordinator recently had an “all hands on deck” week as officials highlighted progress on health IT adoption and fielded questions from a panel of US Senators.  In anticipation of a Senate Finance Committee hearing, CMS released some new data regarding meaningful use participation and health IT adoption, including:

--         200 million electronic prescriptions sent;

--        13 million appointment reminders flagged; and

--         4 million care summaries shared between healthcare providers.

CMS also highlighted their numbers indicating that more than 50 percent of eligible health care professionals and 80 percent of eligible hospitals have begun using electronic health record systems since the meaningful use program launched in 2011.  This translates to almost 310,000 providers being paid a total of $15.5 billion for implementing EHRs.  ONC echoed these figures leading up to Wednesday where a panel of Senators from various parts of the country grilled top officials on progress and a path forward for health IT.

During the hearing, Senator Orrin Hatch (R-UT) said, "I do not want to see progress stalled on implementing the use of technologies,” referring to calls to “pause” the EHR Incentives Program.  “But if we ignore problems along the way and simply expect everyone to catch up, we will end up in worse shape.”  Sen. Hatch was joined by others who worried that small and rural providers were increasingly in danger of falling behind.  However, ONC head Dr. Farzad Mostashari insisted that “a pause in the program would slow the progress that’s been hard-fought,” he said. “A pause would take momentum away from progress.”  CMS Innovation Center Acting Director Patrick Conway echoed the sentiment.

The fun will continue next week, with hearings set again with the Finance Committee in addition to a Health IT Policy and Standards Committee joint hearing on implementation / Stage 2 readiness.  Members of CHIME will be present at both hearings to testify and Washington Debrief will be there to provide coverage.

ONC Standards Group Begins New Pilot

ONC’s Standards & Interoperability (S&I) Framework updated the Health IT Standards Committee this past week and described a new effort designed to enable providers to manage their patients across different care settings and perform data analysis.  Dubbed the Data Access Framework (DAF), the project is similar to the BlueButton initiatives which enable patients to access their own health data, according to officials, except it is focused on enabling providers to access their patient’s data both within and across organizations.  The DAF will identify / create / modify standards to solve basic data access issues faced by providers, both within their own organization and across organizations in a modular and substitutable fashion.  ONC officials said the work of this initiative will be done in 2 phases: Phase 1 is focused on Local Access via Intra Organization Query; and Phase 2 is focused on Targeted Access via Inter Organization Query.  Interested individuals should visit the S&I wiki at:

Doc Fix Bill Emerges with Bi-partisan Support, Sans ‘Pay-for’

Leadership from the House Energy and Commerce Health Subcommittee plan to hold a markup July 22 of a bill to overhaul how Medicare pays physicians, a step forward in repealing the unpopular sustainable growth rate formula.  Energy & Commerce Chairman Fred Upton (R-Mich.) confirmed the Monday markup saying, “I feel pretty good that a week from today, we’re going to be able to approve this in our subcommittee and get it done on a very strong bipartisan basis, and get it out of our committee by the August break.”  The proposed bill was released late Thursday with the support of leading Democrats Henry Waxman (Calif.) and John Dingell (Mich.).  The bill would replace the current SGR with an enhanced fee-for-service system, while allowing providers to opt out and participate in alternative payment models.  In the revised program, providers would get payment updates and incentives based on how they met specified quality measurements.  Missing from the conversation, however, is an answer to how the repealed formula would be paid for.  The Congressional Budget Office estimates the cost of repeal would be $139.1 billion over 10 years.  In years past, this has been the major stumbling block, but the figure is much lower than years past, so Hill watchers are cautiously optimistic.

Now open! CHIME State Public Policy Award for CIO Leadership
The State Public Policy Awardwill be presented during National Health IT Week on September 18 in Washington, DC. (Winner need not be present, but it’s encouraged!) This award recognizes the contribution of a CHIME member engaged in educating policy makers at the state-level on the value of health IT and its role in patient care. You may nominate yourself or a colleague. Submission deadline: Aug. 2, 2013