Home > EHR, meaningful use, Medicare > Senate HELP Committee Explores Challenges in Information-Sharing, Meaningful Use

Senate HELP Committee Explores Challenges in Information-Sharing, Meaningful Use

The U.S. Senate Committee on Health, Education, Labor and Pensions (HELP) convened a full committee hearing regarding “Health Information Exchange: A Path Towards Improving the Quality and Value of Health Care for Patients” on June 10, 2015. The witnesses were Neal Patterson (CEO, Cerner), Christine Bechtel (National Partnership For Women & Families), Dr. Thomas Payne (American Medical Informatics Association), and Craig Richardville (CIO, Carolinas HealthCare System).

The hearing broadly surveyed some of the general challenges facing health information exchange (the verb). A lot of time was also spent on anxiety related to the Medicare/Medicaid EHR Incentive Program (“meaningful use” or MU) and the recent Stage 3 proposed rule for MU in 2018 and beyond. The Chairman, Senator Lamar Alexander (R-TN), and a couple of the witnesses suggested that Stage 3 final rule be delayed until Stage 2 experiences have been collected and leveraged. It did not seem well understood that the Stage 3 proposals were more simplified and flexible for participants than the MU regulations that are currently in effect.

Christine Bechtel, who served on the Office of the National Coordinator for HIT’s Health IT Policy Committee from 2009 to 2015, also attacked the Centers for Medicare and Medicaid Services’ proposal to reduce patient action requirements in the “MU fix: 2015-2017” rulemaking. This proposed change has been misunderstood by some stakeholders as a proposed elimination of the patient electronic access requirement in MU. Bechtel’s written testimony stated:

“We must preserve both the requirement that the technology is in place, and the requirement that a percentage of patients use it at least one time during the reporting period. Regardless of whether the number is five percent or something else, CMS’s recent proposal to drop this threshold to just a single patient will completely undermine efforts by consumers who want to have and use their data. Requiring providers to actively engage with a percentage of patients is an essential mechanism for changing consumer expectations and enabling consumers as a force for change.”

No explanation was provided in the written or verbal testimony for why the proposed change would “undermine efforts by consumers who want to have and use their data.” The MU requirement that patients be enabled to view, download, and transmit their data would not be reduced; only the secondary requirement that a percentage of patients actively use this capability. This secondary requirement has been shown to be controversial and unfair to referral-based specialists, such as diagnostic radiologists, who do not typically have ongoing, continuous relationships with their patients.  It has also been shown to be unfair to rural providers with minimal internet/mobile connectivity and those with patient populations who do not enthusiastically engage with their personal health data online.

The Senate HELP Committee will convene additional hearings in the coming weeks to explore the issues of physician regulatory burden and ownership of exchanged health data.

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Categories: EHR, meaningful use, Medicare
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