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Washington Debrief: Senate Panel Examines HIE, Patient ID Challenges Highlighted

June 15, 2015
by Leslie Kriegstein, Interim Vice President of Public Policy, CHIME
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Congressional Affairs:

Senate Panel Examines HIE, Patient ID Challenges Highlighted

Key Takeaways: The Senate HELP Committee, in the first of a series of hearings, heard from health IT experts on ways to improve health information exchange.

Why It Matters: The series of hearings will culminate in a set of recommendations for legislative and regulatory actions to address ongoing concerns with federal IT programs, including the meaningful use Program, as well as provider usability and workflow challenges.

Among the issues highlighted was the challenge of confidently identifying patients with their data. Senator Elizabeth Warren (D-MA) cited a 2012 CHIME study of 128 healthcare CIOs and other senior healthcare leaders in which nearly one-fifth indicated that their hospital had experienced an adverse event during the course of the year due to a patient information mismatch.  The Senator spoke to the dangers of patient mismatches and called on witnesses to articulate what Congress and the Office of the National Coordinator for Health IT (ONC) can do to solve this patient safety issue.

CHIME member Craig D. Richardville, MBA, FACHE, Senior Vice President and Chief Information Officer at Carolinas HealthCare System, was among the panel of witnesses. Richardville outlined several factors for creating a pathway to achieving interoperability including a functional set of standards, data transparency and government-led collaboration among providers, patients, vendors and payers.

Other reform proposal discussed included a delay in the rulemaking and implementation of meaningful use Stage 3, clarifying the government’s role in standards identification and additional resources for health information exchanges.

The next hearing is scheduled for Tuesday, June 16, entitled “Achieving the Promise of Health Information Technology: What Can Providers and the U.S. Department of Health and Human Services Do To Improve the Electronic Health Record User Experience?” A third hearing has been announced focused on patient access to their healthcare data, to be chaired by Senator Susan Collins (R-ME.)

Another Breach and New Details on Federal Breaches Prompts Call from President, Congressional Leaders for Action on Cybersecurity Legislation

Key Takeaway: President Obama was among those calling on Congressional leaders to advance cybersecurity legislation in the wake of breaches at a federal agency and health IT vendor.

Why It Matters: Following the breach at the Office of Personnel Management (OPM), in which an estimated 14 million employee records may have been compromised, President Obama called on Congress to pass legislation to improve cyber threat information sharing between the public and private sectors.

In possibly the first breach of an electronic health record (EHR) vendor, Medical Information Engineering (MIE) revealed last week that it suffered a data breach affecting the some clients’ electronic medical records. MIE also divulged that its PHR platform, NoMoreClipboards, was also penetrated during the breach.

In response to the new details on the OPM breach and President Obama’s request, Senate Majority Leader Mitch McConnell (R-KY) brought the Cyber Intelligence Sharing Act (CISA) of 2015 to the Senate floor for consideration. Falling four votes short, the CISA bill was not considered as an amendment to the National Defense Authorization Act. Many Democrats cited interests in strengthening privacy protections for consumers who have been the victims of a breach.

CISA passed the Senate Intelligence Committee on a 14-1 vote in March but no action has been taken since. Industry groups including CHIME, have been pushing for a June floor vote, in order reconcile the bill with two cyber information sharing bills that passed the House in April.

Federal Affairs:

CHIME Says Mandatory Reporting of eCQMs Unrealistic in 2016 in IPPS Response

Key Takeaway: CHIME called CMS’ proposal to requirement of eCQM reporting in 2016 unreasonable in comments submitted last week.

Why It Matters: The 2016 Inpatient Prospective Payment System (IPPS) proposed rule released on April 30, CMS proposed to make the electronic submission of clinical quality measures (CQMs) mandatory in 2016.

In the comments submitted last Friday, CHIME acknowledged the importance of the agency’s interest in aligning and harmonizing measures across hospital quality reporting programs and highlighted the sincere challenges with the proposed mandate of electronic submission of quality measures (CQMs) beginning in 2016.

Further, CHIME requested CQMs be employed only upon proper maturity. “In keeping with previous recommendations to CMS, CHIME believes it prudent to require electronic submission of eCQM data after such time when federal regulators rigorously test and validate the accuracy / completeness of CQMs required by Medicare and Medicaid.”

CHIME comments suggested CMS move forward with stated plans to allow dual submission of EHR Incentive Payment Program and a subset of IQR Program CQMs on a voluntary basis, offering support for CMS’ plans to issue the Request for Information (RFI), so technical and workflow barriers can be identified and addressed over the next two yearly cycles.

MU participation in 2014 Highest Yet, Says CMS

Key Takeaway: Participation in the EHR incentive program for 2014 was the highest since the program started, according to CMS data released last week.