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Healthcare IT on the Hill

June 23, 2010
by Jennifer Prestigiacomo
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Web Exclusive Interview: Justin Barnes, Chairman, Electronic Health Records Association

Last week was National Health IT week (June 14 – 18) in D.C. During the week, the HIMSS Public Policy Summit convened to talk about current healthcare IT issues. Healthcare Informatics Associate Editor Jennifer Prestigiacomo caught up with Justin Barnes (vice president, marketing and government affairs, Greenway Medical Technologies), chairman of Electronic Health Records Association, the HIMSS EMR trade association, to get the scoop on how the summit went and what were the current hot-button issues he’s working on.

Healthcare Informatics: How did National Health IT week go? Were there any interesting developments at the HIMSS Public Policy Summit?

Justin Barnes: On the whole, National Health IT week went very well. There was certainly more excitement than ever before for healthcare IT, even as financial pressures continue to mount for the country. [The focus was] updating the core infrastructure of our healthcare system and creating a much more efficient healthcare system overall. You’re starting to hear that literally from congressmen and senators that you didn’t hear from them before. Even though ARRA (American Recovery and Reinvestment Act ) has already been passed and we’re in 16 months into implementation, you’re starting to hear even more support for healthcare IT and even conversations on how we can improve the legislation and on the regulatory side too. That was impressive. That was something I had not really heard a lot before last week. To have that come out of the Policy Summit and National Health IT week was positive.

A lot of us were able to respect the progress that has been made in health IT in obviously passing the HITECH Act, but also the volume of work we still have to do. So, we all stay humbled by the immense amount of work that still needs to be done with the national implementation of health IT.

HCI: Can you briefly describe the recommendations EHRA made in March to the Office of the National Coordinator for Health Information Technology (ONC) or the Centers for Medicare & Medicaid Services (CMS)?

Barnes: For one, get the rules out as fast as possible. People need time to digest them and time to implement the certification processes and include certification criteria in our product timelines and get our products certified. On the meaningful use side, [we need] to have thresholds that can be achieved by eligible hospitals and professionals across the country. And to keep in the forefront of all of these decisions, these are incentives for doctors to adopt. So no matter what you do, you want to keep this process as an incentive to adopt health IT and create metrics around CPOE and e-prescribing. You want to create criteria that eligible professionals and hospitals can successfully implement in appropriate stages. We have a Stage 1 that is achievable that is truly an incentive and we have the best base to work off from and really hit our long term goals around health IT adoption. A great culmination of National Health IT week was the certification process final rule being published last Friday.

HCI: Have you heard any feedback from the ONC or CMS regarding the EHRA recommendations?

Barnes: I think the public statements that we’ve heard from Dr. Blumenthal (David Blumenthal, M.D., National Coordinator for Health IT), as well as other ONC officials is that they’ve listened to a lot of public comments and that things will come out in line with a majority of what the industry expects. From what I’ve heard publicly and read, they have listened. If you go back to all the meaningful use testimony last April by NCVHS (National Committee on Vital and Health Statistics) where 40 people testified and 70 percent of our testimonies synced up in all the key areas—so that was very encouraging to see this early on in the process.

HCI: What recommendations has EHRA made to the ONC in regards to vendor certification under the HITECH Act?

Barnes: It’s very important to get temporary certification out there as fast as possible and allow for vendors and users and other stakeholders to be more involved in the certification criteria. That is something we’ve certainly asked for. And we’ve seen overall that most of our comments were respected and implemented. It’s exciting to see that remote testing is going to be available because initially they had said that it was only onsite testing. One of our key points in our documents to the ONC and our public documents in general is about product lifecycles. We need 18-month lead times to build criteria and metrics into our solutions, if its meaningful use criteria, certification criteria, or standards criteria; our products need lead times so we can build them in to make them the most efficient solutions out there. We’ve seen some of those timelines being incorporated into the processes, so that was great to see.

HCI: Tell me a little about what you learned in your tenure as EHRA Chairman?

Barnes: I’ll be transitioning from chairman to chairman emeritus, so I’ll stay very active in the association and the industry. I was chairman for two years, and what I learned the most is that our industry as a whole really agrees on most major components of health IT adoption standards. The collaboration that I have witnessed and been a part of has been very rewarding in many ways. What I learned is we work well as an industry and in many ways we’re competitors, but we work together seamlessly for the common good and that was very humbling to be a part of. The opportunity for us to make a great difference and we and the other leaders in the industry have been able to accomplish in the past couple of years around health IT and ensuring that Congress as well, as the administration truly understands that health IT is essential to any type of healthcare transformation that this country needs to go through. I didn’t say healthcare reform, I said healthcare transformation—health IT is the essential infrastructure and everybody needs to invest in that. The federal government needs to step up.

HCI: What challenges have you met during your tenure?

Barnes: The biggest challenge that turned out to be successful was ensuring the HITECH Act stayed intact in ARRA. That came down to last second negotiations and discussions. I think that the volume of initiatives coming out, whether it’s coming out on the regulatory side, whether it’s FDA (Food and Drug Administration), ONC, CMS. You’ve got a lot of initiatives coming out and where to focus your time and energies is certainly a challenge.

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