Thursday, May 14, 2015

Legislation to promote interoperability of electronic health records

The U.S. House of Representatives’ Energy and Commerce Committee will consider language designed to ensure that electronic health information systems are interoperable (can talk to each other) as part of its markup of the so-called 21st Century Cures legislation by Chairman Fred Upton, R-Mich., and Diana DeGette, D-Colo.

This reported by Congressional Quarterly.

In an interview last week, Texas Republican Michael C. Burgess told Congressional Quarterly that he has long been concerned about incentive programs to get health care providers to adopt electronic health record systems, which were included in the 2009 stimulus package. In his view, the programs pushed a lot of money out the door without a clear plan for what should be accomplished and the results have been disappointing.

Burgess told Congressional Quarterly that his effort will build on interoperability provisions in a recently-enacted law that changes the way Medicare doctors are paid. The legislation set a national goal of achieving widespread exchange of health information through certified technology by the end of 2018. (NAHAM News will be looking into this.)

The American Hospital Association cited the Medicare law’s new interoperability requirements and maintained that putting additional constraints on providers is unnecessary and could limit flexibility.  AHA recommended that the committee focus on developing policies that ensure vendors are accountable for designing and supporting interoperable products.

Vendor accountability? 
The American Medical Association reportedly favors language that instructs the administration to develop tools to ensure that recipients and patients are accurately identified, among other things.

Accurate patient identification? Wow, but I digress again.

The AMA pointed to the federal incentive program for "meaningful use" in outlining the problems with interoperability.

The existing program gives Medicare or Medicaid bonus payments to physicians, hospitals and other providers who demonstrate that they "meaningfully use" electronic health records and in later stages, penalizes providers who don't comply.

Physicians and the companies that sell the technology are focused on meeting the complex requirements of the existing program "and often do not have the time and resources to focus on actions that fall outside of the numerous MU measures—including interoperability.”

Congressional Quarterly also reports that the Senate Health, Education, Labor and Pensions Chairman Lamar Alexander also wants to address concerns about electronic health records, though his committee is not as far along as the House. From Senator Alexander –

The federal government has spent $28 billion to speed the adoption of electronic health records, and the result is that doctors don’t like the systems and many say they disrupt workflow, interrupt the doctor-patient relationship, and haven’t been worth the effort. We are working in the Senate health committee to identify the five or six things that Congress or the administration can do to help make the failed promise of electronic health records something that physicians and providers look forward to instead of something they endure.

Stay tuned. We’ll keep an eye on this legislation.

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