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Washington Debrief: Sebelius Responds to GOP Senators on HITECH Criticism

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

CHIME Says More Standards, Certification Would Drive Interoperability & Health Info Exchange The government should explore ways to extend the concept of certification to the health information exchange marketplace to advance interoperability, CHIME said in comments submitted to the Department of Health and Human Services (HHS) this week.  The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator (ONC) for Health Information Technology recently released a joint request for information (RFI) March 7, outlining several possible changes to policies and programs to advance interoperability and health information exchange.  Some questions in the RFI seek feedback on the ability of payment system reforms, such as ACOs or bundled payments, to advance interoperability; other questions ask if changes to Conditions of Participation might be leveraged to encourage more exchange.  CHIME answered all the questions posed by CMS and ONC in their response, focusing on a need to address technical barriers related to exchange. “CHIME believes that the certification process, developed under the EHR Incentive Payments program, has had a major impact on the adoption and meaningful use of health information technology,” the organization said in a response to the RFI.  “As a policy lever, the impact of certification criteria developed for Meaningful Use cannot be understated.  Thus, CHIME recommends HHS extend the concept toward the health information exchange market, via standard interfaces, standard methods for isolating sensitive information, standard means to securely transport patient care information (i.e., Direct), standard ways to accurately identify patients and standard protocols for tracking consent.”

Senators Question Effectiveness of HITECH Implementation Six Senators sent letters to HHS Secretary Kathleen Sebelius and health IT stakeholders seeking information on HITECH implementation and asking for feedback on a “white paper” outlining several concerns with Meaningful Use, oversight and progress on interoperability.  The Senators included:

  •          Senators John Thune (R-N.D.)*
  •          Lamar Alexander (R-Tenn.)
  •          Pat Roberts (R-Kan.) *
  •          Richard Burr (R-N.C.)*
  •          Tom Coburn (R-Okla.)*
  •          Mike Enzi (R-Wyo.)

“The ultimate goal of this act was to create standards for the secure exchange of patient data nationwide,” the group of Republican senators wrote in a report, Reboot: Re-examining the Strategies Needed to Successfully Adopt Health IT.  “…we see evidence that the program is at risk of not achieving its goals and that $35 billion in taxpayer money is being spent ineffectively in the process.”  The Senators have five areas of concern, including: (1) Lack of clear path toward interoperability; (2) Increased costs; (3) Lack of oversight; (4) Patient privacy at risk; (5) Program sustainability.  There are three specific areas where input by stakeholders is sought by the senators, including questions over “data lock-in” timing of Stages 2 and 3 of Meaningful Use and steps CMS needs to take before implementing Stage 3.

In response to the report, Secretary Sebelius said, “We haven’t gotten to implementation of Stage 2 yet,” Sebelius said in a recent Senate Finance Committee budget hearing. “You might be reading the final chapter before we launch it.”  The Senate letter to HHS Secretary Sebelius is similar to one sent by the Senate Finance Committee last year, seeking additional information about the current state of the program.  Four of the six senators who signed the April 2013 letter authored the October 2012 letter (Senators Thune, Roberts, Burr and Coburn).

Nearly $1.5M Set Aside to Tackle Healthcare Data Challenges in National Contest A Washington-based policy think tank, a California-based provider network and a global research, technology, and consulting firm announced a series of “challenge” or “prize” contests this week.  The Bipartisan Policy Center, Heritage Provider Network and The Advisory Board Company announced the Care Transformation Prize Series, a national contest meant to address “difficult data challenges,” facing providers as they implement delivery system and payment reforms.  The briefing held in Washington was meant to kickoff the effort and encourage healthcare providers to submit their most difficult data challenges.  To incentivize participation the three organizations will offer at least three quarterly prizes of $100,000 to teams that develop the best solutions for the selected challenges.  The winning algorithms then will be made available to health care organizations and the public.  “Over the next two years, this contest will inspire innovative solutions for health care organizations as they learn how to leverage large data, particularly clinical data sets, for reform efforts,” said HPN President and CEO Richard Merkin, M.D.