Jeff Smith, vice president of public policy at the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME), is helping the healthcare IT executive leaders’ national association to make major waves on Capitol Hill and at federal agencies these days. The Washington, D.C.-based Smith sees the present moment as a time of great opportunity for CHIME and other healthcare professional associations to have a real impact on federal policymakers in Congress, the administration, and federal agencies, as healthcare IT becomes ever more critical to healthcare system reform efforts.
Last week, Smith sat down with HCI Editor-in-Chief Mark Hagland at the CHIME Washington, D.C. offices, to converse about some of the policy and political currents that CHIME and the other healthcare professional associations are working through these days. Below are excerpts from their interview.
When you look at the legislative and regulatory landscape in Washington, D.C. right now, how would you characterize that landscape overall?
To use a maturity analogy, over the past five years, we’ve gained enough experience with health IT policy to know that there are areas for improvement [with regard to policy development]. And I think when you look at the legislative and regulatory landscape, you see a lot of people in Congress and in the federal agencies who want to help. And when multiple parties want to help, multiple parties have different solutions. So for those of us who work in health IT policy, the real challenge is understanding which policies will jibe together, and which will be detrimental. So whether you’re talking about the Ellmers bill that would shorten the meaningful use reporting period to 90 days [the Flexibility in Health IT Reporting Act of 2015, or “Flex-IT Act,” introduced in mid-January by Rep. Renee Ellmers (R-N.C.)], or the SOFTWARE [Sensible Oversight for Technology which Advances Regulatory Efficiency] Act, which would essentially prohibit the FDA [Food and Drug Administration] from regulating health IT in the same way that agency regulates medical devices; what you see is people trying to be helpful.
The challenge for us is trying to figure out which bills are going to be helpful, which bills are going to be a complement to what the federal agencies are doing, and which bills are going to be the opposite. Health IT is now very much on the policy radar in the last year and a half. And for the most part, that’s a very positive development, because it means that people are paying attention; but it also means they could mess things up. So it’s a very busy space, a very active time for health IT policymaking.
Do you think there’s a level of understanding now on the Hill regarding what’s actually going on in the healthcare industry?
Yes, I would say that the degree of understanding on the Hill is actually higher than it was five years ago. But there’s a constant turnover of members and staffers; so there’s always going to be a need to educate, and to help to flatten the learning curve.
What are the biggest issues for you right now as an association, with regard to policy initiatives on the Hill?
In comparison to other years, the SOFTWARE Act, trans-industry cybersecurity legislation that might affect healthcare as one of other industries, as well as other pieces of legislation, are all out there and in play on the Hill. Meanwhile, meaningful use is still a very big deal for us. We are trying to make that program sustainable, trying to figure out if there is a gap between what the federal agencies want to do with meaningful use, and what’s going to make it most pragmatic for those who have to implement it.
So right now, that’s where there’s a lot of focus for us. And having the Stage 3 rule proposed now will help, as we’ll be able to see where the federal agencies are at mentally; so we can go back and see where they’re on track and where they need help. I would be surprised if there were additional pieces of legislation coming out this year relative to meaningful use, depending on how the industry internalize the proposed rules, and depending on how HHS [the Department of Health and Human Services] articulates final rules, you could see legislation being devised. But a lot of it goes back to macro-dynamics. And by that, I mean is, are more than 50 percent of physicians being successful with meaningful use? I think if that number gets closer to 75 percent, policymakers will be put more at ease. If hospital participation remains at the level it is now, they’ll be OK. But if Stage 3 is seen as a problem, then we’ll have to figure out what to do.
Tell me more about CHIME’s initiative around the national patient identifier issue?
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