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Health IT Legislation Would Establish Consumer Rating System for EHRs

October 7, 2015
by Rajiv Leventhal
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Legislation introduced on Oct. 6 from U.S. Senators Bill Cassidy, M.D. (R-LA) and Sheldon Whitehouse (D-RI) focuses on making health IT systems accountable for their performance in three key areas: security, usability, and interoperability. 

Specifically, the bill, the Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act of 2015, would help ensure that certified health IT systems are performing as promised in the field, and establish a rating system that will enable consumers to compare different products based on that performance.

The TRUST IT Act is focused on making health IT systems accountable for their performance in three key areas: security, usability, and interoperability. Specifically, the bill will establish a Health IT Rating System—to be published on the Office of the National Coordinator for Health Information Technology’s (ONC’s) website—to enable consumers to compare certified health IT products on those three criteria. The Rating System would be developed through an open and transparent stakeholder input process.

The bill also establishes a process for the collection and verification of confidential feedback from health care providers, patients, and other users on the usability, security, and interoperability of products; and from health IT vendors on practices of health IT users that may inhibit interoperability. It requires health IT vendors to report on the performance of their health IT products every two years and authorizes the assessment of fines—and in some cases decertification of products— for failing to report.  The fines collected would be used to create a revolving user compensation fund to help offset costs of purchasing new certified health IT for users whose health IT was decertified.

What’s more, the TRUST IT Act will enhance the federal certification system for health IT products by:

  • Authorizing ONC to make publicly available information, such as summaries, screen shots, or video demonstrations, showing how certified health information technology meets certification requirements;
  • Requiring the certification program to establish that health IT products meet applicable security requirements, incorporate user-centered design, and achieve interoperability, consistent with the reporting criteria developed for the Health IT Rating Program;
  • Requiring health IT vendors to attest they do not engage in certain information blocking activities, including nondisclosure clauses in their contracts, as a condition of certification and maintenance of certification;
  • Authorizes the Inspector General of the Department of Health and Human Services to investigate claims of information blocking and assess civil monetary penalties on any person or entity determined to have committed information blocking.

“As a physician, time is better spent looking into a patient’s eyes to make sure that she comprehends that even though she has cancer, there is hope—as opposed to clicking through a computer screen to document something unimportant to her and required by someone far removed from the exam room,” Dr. Cassidy said in a statement. “This bill implements better coordination in the electronic health records (EHRs) system. Doctors will be able to better care for their patients and in turn, deliver on the promise that their information is being used for their benefit and not for the benefit of others.”

Sen. Whitehouse added, “Right now, after a health IT product is certified for use, there’s no way to ensure that it continues to deliver as promised for doctors and patients, and no way to easily compare one product to another. This bill will establish important safeguards to prevent systems from underperforming and will grade them on their performance – changes that will improve market competition and drive innovation.  I thank Senator Cassidy for working with me on this bill and I hope we will have to opportunity to consider it in the HELP Committee in the months ahead.”

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