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Washington Debrief: With Shutdown Over, HIT Stakeholders Focused on MU Extension

October 22, 2013
by Jeff Smith, Director of Public Policy at CHIME
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Jeff Smith, Director of Public Policy at CHIME

Government Shutdown Over, Focus Turns to MU Extension, Accounting of Disclosures  With the government shutdown behind us, health IT stakeholders in Washington are resuming focus on a pair of priority issues for 2014, the proposed MU2 extension and accounting of disclosures.

CHIME has already led the way towards engaging Congress on the need to allow flexibility on Meaningful Use in 2014. A few weeks ago, 17 US Senators sent a letter to HHS recommending a year-long extension for providers who need it, while enabling those providers who can meet Stage 2 requirements to do so.

In comments made during a plenary session on October 9 at the CHIME13 Fall CIO Forum, former National Coordinator Dr. Farzad Mostashari advised providers not to count on additional time to meet Stage 2 or Stage 1 revised criteria in 2014. He underscored the difficulty of getting regulatory changes made at a time when healthcare politics over the Affordable Care Act threatens to be conflated with HITECH and the EHR Incentives program. Despite such comments, CHIME will continue to talk with member CIOs and Foundation Firms to gain a clear understanding of how implementation is progressing. CHIME will also continue to work with CMS, ONC and members of Congress to make sure providers have the flexibility they need to implement new 2014 Edition certified EHR technology safely and correctly.

Another issue of emerging interest is that of Accounting of Disclosures. Recently, the Health IT Policy Committee’s Privacy and Security Tiger Team issued a request for comment asking for perspectives on what it takes to provide patients with an accounting of disclosures using IT. Specifically, they are looking to find appropriate ways to bring transparency and bolster privacy to the delivery of healthcare. CHIME submitted comments saying that production of an access report is technologically unfeasible and production of an Accounting of Disclosures report for Treatment Payment and Operations across multiple information systems is enormously difficult, expensive and cannot be achieved with technology alone. “Of chief concern to many CIOs is that all audit logs are not created equal. Despite having common data elements recorded across different solutions, there are few, if any, standard ways to generate reports. Stemming from this issue is the complicated and costly task of aggregating audit logs from different systems into a singular report.”

As with the MU extension work, CHIME will work with health IT stakeholders to educate federal policymakers on the benefits and challenges of providing access reports and accounting of disclosures in a digital world.

Healthcare Website Woes Garner Congressional Focus After Shutdown  Just because the government has resumed operations, does not mean that Congress is entering a new era of compromise and agreement. Instead, Senate and House detractors of the Affordable Care Act have doubled down on their calls to have the law repealed due to the hampered performance of, the HHS portal to buy health insurance. So far, the numbers indicate that millions of people have visited the website, yet only a small fraction have actually purchased insurance due to glitches and technical flaws in the software. On the wings of such problems, the House Energy and Commerce Committee will hold hearings later this week and a bi-cameral call from Republicans is asking for the resignation of HHS Secretary Kathleen Sebelius. While these calls represent a minority within a minority, it is an indication of where Congress is likely to take its focus heading into 2014 and a signal that controversy will continue into the foreseeable future.