In a letter to Seema Verma, Administrator of the Centers for Medicare and Medicaid Services (CMS), the American Academy of Family Physicians (AAFP) voiced it support of the MyHealthEData initiative, but also called for some improvements to certain aspects of the fledgling patient data initiative.
CMS Administrator Seema Verma, M.P.H., publicly unveiled the MyHealthEData Initiative on March 6 during a speech at the Healthcare Information and Management Systems Society (HIMSS) annual conference in Las Vegas.
During her speech, Verma said the initiative is designed to empower patients around a common aim - giving every American control of their medical data. “MyHealthEData will help to break down the barriers that prevent patients from having electronic access and true control of their own health records from the device or application of their choice. Patients will be able to choose the provider that best meets their needs and then give that provider secure access to their data, leading to greater competition and reducing costs,” Verma said.
According to CMS, the initiative is headed up by the White House Office of American Innovation with active participation from the U.S. Department of Health and Human Services (HHS), CMS, the Office of the National Coordinator for Health IT (ONC), the National Institutes of Health (NIH) and the Department of Veterans Affairs.
Verma also announced an update to the agency's Blue Button initiative, calling the new Blue Button 2.0, a developer-friendly, standards-based application programming interface “that enables Medicare beneficiaries to connect their claims data to secure applications, services and research programs that they trust.”
The AAFP states that it supports certain portions of the new initiative; however, “other key points raised eyebrows among Academy leaders.”
In a March 14 letter to Verma, signed by AAFP Board Chair John Meigs, M.D., of Centreville, Ala., the organization weighed in on important portions of the initiative during its formative stages to ensure the final program doesn't create more obstacles to already overburdened family physicians. The AAFP noted its approval of agency efforts that "encourage patients to have meaningful control of their data" and to improve interoperability and administrative simplification."
According to the AAFP, to achieve improved, secure patient access, actual interoperability of electronic health care records is first required, something practicing physicians were promised when they purchased and updated their systems to Certified Electronic Health Record Technology (CEHRT). However, many systems do not meet this standard, the association noted.
“Lack of this promised interoperability leaves physicians beholden to EHR vendors—a situation that has allowed vendors to engage in price gouging when peddling software upgrades and maintenance,” AAFP stated. “We strongly urge CMS to require EHR vendors to provide any new government-required updates to such systems without additional cost to the medical practice.”
Multiple studies have shown that physicians spend far too much time—up to 50 percent of their workday and even after clinic hours—using their EHRs, said the AAFP. “CMS must take the time and financial costs physicians endure into account while addressing improved patient access to health care data,” the AAFP stated in the letter.
In her speech, Verma zeroed in on CMS' intent to prevent providers and hospitals from blocking patients—and their physicians—from seeing personal health data. In response, the AAFP noted in its letter to Verma that too often physicians receive summaries of care that are too long and “filled with clinically irrelevant information.” Indeed, said the letter, unnecessary information often is inserted into summaries by automated processes “designed to ensure compliance with CMS regulations and requirements for the MU (meaningful use) and ACI (advancing care information) programs.”
The AAFP is urging CM to improve its regulatory requirements and focus on “how and when data is exchanged rather than focusing on the data in the exchange.”
Furthermore, the AAFP called on CMS to use the authority it was granted in the 21st Century Cures Act to penalize health care organizations that are not sharing information. “Policies should be focused on penalizing bad actors blocking information,” the AAFP stated in its letter.
The AAFP addressed additional points in its letter to CMS, including suggestions related to:
- streamlining requirements associated with meaningful use and the Quality Payment Program's advancing care information component;
- interoperability of quality measures, including elimination of all health IT utilization measures and implementation by all payers of the Core Quality Measures Collaborative's core measures sets championed by the AAFP;
- widescale interoperability of patient admission, discharge and transfer data in as close to real time as possible; and
- reducing hospital admissions and readmissions, and duplicative testing.
“With the modifications we have suggested and attention to other overarching health care IT issues as outlined above, we believe these programs will lead to great success for our patients by catalyzing better, more efficient quality care,” AAFP stated in the letter.
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