ONC’s HIT Standards Committee and HIT Policy Committee-MU Workgroup Discuss Early Plans for Exploring Imaging Standards
In separate meetings earlier this week, the Office of the National Coordinator for HIT (ONC) HIT Standards Committee (HITSC) and HIT Policy Committee-Meaningful Use (MU) Workgroup discussed tentative plans for exploring medical imaging. Ensuring patient and provider access to diagnostic imaging data has been a staple of the American College of Radiology’s advocacy efforts related to the EHR Incentive Program for nearly three years.
On December 14, an ONC staff presentation regarding potential priorities for 2012 stated that “radiology standards” would be explored by the HITSC in the second quarter of next year. Dr. John Halamka (co-chair, HITSC) highlighted the HITSC’s intentions for those future discussions on his blog.
On December 15, the HITPC MU Workgroup met to explore, among other things, the outcome of the November 28 Specialist Subgroup conference call. It was mentioned that the HITSC is interested in collaborating with the HITPC (meeting, tiger team, or something else) regarding the topic of imaging. The MU Workgroup members seemed to generally agree with the concept.
It is imperative that the ONC, HITPC, and HITSC reach out to the established imaging informatics community to adequately inform any future efforts related to imaging standards.
RBMA, ACR and Other Stakeholders Meet With ONC to Discuss Hospital-Located EPs Without Physical Practice Infrastructures
Yesterday, representatives from the Radiology Business Management Association, Healthcare Billing and Management Association, Medical Group Management Association, and American College of Radiology met with Office of the National Coordinator for HIT staff to discuss considerations and complications related to EHR Incentive Program (“meaningful use”) participation by eligible professionals (EPs) in hospital-located practices that do not have physical infrastructures.
EPs in these practice scenarios rely on the helpfulness of their hospitals, via technology and/or data access, to satisfy the various requirements of the program. Several hospital-located practices, particularly those in small community hospitals, have encountered barriers in trying to work with hospitals on EP compliance.
The two primary “asks” for the meeting were:
- Provide information/guidance for hospitals regarding compliance facilitation for EPs who are not technically “hospital-based” but work in, or for, hospitals.
- Work with CMS to define a future significant hardship exemption option for certain hospital-located EPs who are not adequately enabled by their facilities to participate. Of course, the future significant hardship exemption mechanism is required by statute to have a five-year maximum and an annual application requirement. It could never be a permanent fix without new legislation.
CMS Publishes Final Rule on Release of Medicare Claims Data for Performance Measurement by Qualified Entities
On December 7, the Centers for Medicare and Medicaid Services (CMS) published its final rule to implement Section 10332 of the Affordable Care Act allowing the release and use of standardized extracts of Medicare claims data for quality measurement. Under this rule, “qualified entities” can purchase (at cost) access to certain Medicare claims data extracts and use the data to develop and publish reports about the performance of providers and suppliers. The qualified entities are required to combine the Medicare data with non-Medicare claims data in the development of the evaluations.
Prospective qualified entities must meet certain eligibility criteria, successfully navigate an application/review process, and sign a data use agreement. Qualified entities are required to ensure the privacy and security of the data and are prohibited from using the data for any purpose other than the specific evaluation. Furthermore, qualified entities must give providers/suppliers who are the subject(s) of the report an opportunity to review and suggest corrections prior to publication.
Meaningful Use Workgroup-Specialist Subgroup Changes Course; HIT Standards Committee to Discuss Imaging
On November 28, the Office of the National Coordinator for HIT’s (ONC) HIT Policy Committee/Meaningful Use (MU) Workgroup/Specialist Subgroup held another conference call to discuss MU and specialized medicine. This time, the discussions were led by the co-chairs of the full MU Workgroup, Drs. Paul Tang and George Hripcsak, instead of Dr. Michael Barr, who led the Specialist Subgroup’s promising discussions in October.
It was apparent from the change in leadership and messaging that the MU Workgroup leaders wanted the Specialist Subgroup discussions to move in a different direction. They decided that some specialties’ MU compliance concerns were essentially incorrect (they picked on Geriatrics in particular), and that the proper course of action would be for ONC staff to annotate/address those concerns. This discussion was a disappointment to physician organizations who were hoping that the Specialist Subgroup would bring about proactive engagement of physician organizations and more robust HIT Policy Committee recommendations to increase the relevance of the program to specialists and their patients.
The Specialist Subgroup also learned from ONC staff that the HIT Standards Committee is going to explore imaging standards in late 2011 and early 2012. The ACR is working to ensure that ONC staff and HIT Standards Committee members are informed by the imaging informatics community when they examine this topic.
On November 30, the U.S. Department of Health and Human Services (HHS) officially announced its intent to extend Stage 1 meaningful use (MU) requirements until 2014 for those who began compliance in 2011. The Centers for Medicare and Medicaid Services (CMS) and Office of the National Coordinator for HIT (ONC) originally envisioned that meaningful users would be in each stage for two years before moving into the next. So, 2011 meaningful users were intended to move into Stage 2 in 2013.
In June 2011, the ONC HIT Policy Committee approved a recommendation for CMS and ONC to provide this Stage 1 extension to increase flexibility for early adopters and give HIT vendors a more reasonable window of time in which to make Stage 2 updates to their products and achieve certification. Dr. Farzad Mostashari, National Coordinator for HIT, publicly stated over the summer that this recommendation would be accepted, thus yesterday’s announcement from HHS was not new information.