Meaningful Use Stage 3 Timeline Unveiled
During a meeting this Tuesday, the Meaningful Use Workgroup of the federal Health IT Policy Committee convened to discuss how Stage 3 Meaningful Use might look. An area of prime concern to the workgroup is care coordination. This was evident by a presentation made by Charlene Underwood, director of government and industry affairs at Siemens Medical, who described the model for a platform that would move providers in the direction of a shared electronic whiteboard meant to improve care coordination. According to Healthcare Informatics, the committee is considering proposing that to meet the criteria for Stage 3 meaningful use, both hospitals and providers must implement a solution that:
- Tracks individual care goals;
- Records care team members, their roles, and their contact information across care settings;
- Tracks tasks/steps and responsible party;
- Feeds population health management;
- Facilitates reconciliation of medications, problem lists, goals, and plan of care; and
- Allows for input and viewing by all care team members, the patient and their caregivers.
The MU workgroup is currently working to make initial Stage 3 recommendations by August 1, so that a Request for Comment can be issued in November and final recommendations can be published by May 2013 and a final transmittal letter sent to HITPC in July 2013.
Unique Device Identifiers Propose Rule Released
A long-awaited proposed rule regarding Unique Device Identifiers (UDIs) was released this week by the Food & Drug Administration. The proposed UDI rule outlines a seven-year timeframe for devices to come into compliance with UDI requirements, starting with high risk class III devices within one year of the final rule and ending with some requirements for class I devices in seven years. According to the FDA and proponents of a UDI system, it should have the ability to improve recalls, track adverse events, and improve supply chain efficiency.
In addition to the labelling requirements of the UDI rule, the FDA is proposing to establish a public database, the Global Unique Device Identification Database (GUDID) “to ensure that the UDI can be used to adequately identify the device through its distribution and use.” The FDA believes the integration of UDIs with electronic patient records and computerized physician order entry would have benefits for the patient as well as clinical workflows.
While many in the hospital world have long-supported such a system, the operational impacts of this regulation are as yet unclear. CHIME’s Policy Steering Committee will examine this proposed rule and CHIME’s Advocacy Community can expect to learn more about how this could affect their organizations in the coming weeks.
Post-SCOTUS Battle Begins: To Implement or Not to Implement
During the week following the Supreme Court’s historic decision to uphold the Affordable Care Act, leaders in Washington drew a line in the sand with Republicans urging state-level resistance and the Obama administration ramping up implementation plans. A group of 73 Republican lawmakers from both houses of Congress urged all states to oppose the creation of state-based exchanges in a letter addressed to state governors this week. Led by Sen. Jim DeMint (R-S.C.) and Reps. Michele Bachmann (R-Minn.) and Jim Jordan (R-Ohio), the Republicans said that refusing to implement a state exchange is the most important thing governors could do to help Congress in repealing the law. The lawmakers said this (in)action would save state resources and would ultimately be “good for hiring and investment” in states that refused to implement exchanges.
Meanwhile, HHS is stepping up pressure, using mainly carrots, for states to move forward with the implementation of insurance exchanges. The agency announced several new rounds of grant opportunities and plans to hold a series of meetings with state officials across the country this month to discuss implementation issues. HHS officials said that the new grants, aimed at helping states develop and maintain certain exchange functions, will be available to states regardless of where they stand in the Exchange establishment process and whether they've received exchange funding or not. The department also unveiled a new guidance document that signals flexibility in how Exchange Establishment cooperative agreement funding is spent.
House Bill Would Extend EHR Payments to Behavior Health
Lawmakers in the House of Representatives unveiled a bill this week meant to extend Medicare and Medicaid EHR Incentive payments to behavioral care providers. Two Democrats and five Republicans are sponsoring H.B. 6043, led by Rep. Marsha Blackburn (R-Tenn.) and Rep. Tom Marino (R-Penn.). The bill largely mirrors a senate bill written by Sen. Sheldon Whitehouse (D-R.I.) in March 2011 by extending Meaningful Use payments to:
- Behavioral health, mental health and substance misuse treatment professionals;
- Clinical psychologists;
- Licensed social workers;
- Psychiatric hospitals; and
- Residential and outpatient mental health and substance misuse treatment facilities.
The Senate bill has not yet moved to a committee vote and prospects for passage, in either chamber, before the end of this term are unlikely.