Se­nate panel seek­ing Stage 3 mean­ing­ful-use de­lay

Modern Healthcare - - NEWS - By Vir­gil Dick­son

A key Se­nate leader said his com­mit­tee will push to de­lay im­ple­men­ta­tion of the Obama ad­min­is­tra­tion’s Stage 3 rules for mean­ing­ful use of elec­tronic health records.

La­mar Alexan­der (R-Tenn.), chair­man of the Health, Ed­u­ca­tion, La­bor and Pen­sions Com­mit­tee, said last week that the de­lay will be one of sev­eral rec­om­men­da­tions his com­mit­tee will make to the ad­min­is­tra­tion about EHR reg­u­la­tion.

The Amer­i­can Med­i­cal As­so­ci­a­tion and the Med­i­cal Group Man­age­ment As­so­ci­a­tion have sought a de­lay in Stage 3 rules, which aim to ex­pand shar­ing of pa­tient records be­tween providers. The rules are due to go into ef­fect in 2017.

Other rec­om­men­da­tions the Se­nate com­mit­tee is likely to make to the Obama ad­min­is­tra­tion will cover stan­dards clar­i­fy­ing that pa­tients own their own health data; in­ter­op­er­abil­ity; height­ened se­cu­rity re­quire­ments for pa­tient data; and more user-friendly EHR sys­tems, Alexan­der said.

If leg­is­la­tion is ul­ti­mately needed to get those rec­om­men­da­tions im­ple­mented, they likely would be rolled into the Se­nate ver­sion of the House’s 21st Cen­tury Cures Act leg­is­la­tion. Alexan­der said he ex­pects the Se­nate ver­sion to be drafted and voted on early next year.

In March, the CMS is­sued pro­posed rules for Stage 3. This fi­nal stage re­quires providers to send elec­tronic sum­maries for 50% of pa­tients they re­fer to other providers, re­ceive sum­maries for 40% of pa­tients who are re­ferred to them, and rec­on­cile past pa­tient data with cur­rent re­ports for 80% of such pa­tients.

Healthcare providers are con­cerned that the Stage 3 rules put them at the mercy of other providers in terms of com­pli­ance.

Ac­cord­ing to a new anal­y­sis by Niam Yaraghi, a fel­low at the Brook­ings In­sti­tu­tion’s Cen­ter for Tech­nol­ogy In­no­va­tion, if providers do not send elec­tronic sum­maries, the med­i­cal provider who was sup­posed to have re­ceived them will have failed to com­ply with the rule­mak­ing.

“This leads to a sit­u­a­tion in which even tech-savvy providers will not be able to ful­fill the re­quire­ments of the third stage of the mean­ing­ful-use pro­gram, re­gard­less of their in­ten­tions and ef­forts,” Yaraghi wrote.

Alexan­der’s news brief­ing came af­ter his com­mit­tee’s hear­ing on “in­for­ma­tion block­ing.”

“There is sub­stan­tial ev­i­dence that some or­ga­ni­za­tions are in­ten­tion­ally set­ting up bar­ri­ers be­tween their sys­tems and other sys­tems, over­charg­ing or cre­at­ing tech­ni­cal or le­gal bar­ri­ers to providers who want to ac­cess in­for­ma­tion through the sys­tem they’ve pur­chased, or both,” Sen. Patty Mur­ray (D-Wash.) said at the hear­ing.

Wit­nesses at the hear­ing gen­er­ally op­posed new reg­u­la­tions to ad­dress the block­ing is­sue.

In April, the Of­fice of the Na­tional Co­or­di­na­tor for Health In­for­ma­tion Tech­nol­ogy is­sued a re­port stat­ing that most al­le­ga­tions of in­for­ma­tion block­ing in­volve provider busi­ness prac­tices rather than prob­lems with EHRs them­selves.

“At­tempts to re­dress the root causes of in­for­ma­tion block­ing must ad­dress the un­will­ing­ness of some providers and their EHR part­ners to share and ex­change data,” Dr. David Kibbe, a se­nior ad­viser to the Amer­i­can Academy of Fam­ily Physi­cians, said at the hear­ing.

“That un­will­ing­ness,” he added, “orig­i­nates in the cur­rent busi­ness mod­els of some healthcare provider or­ga­ni­za­tions, and the healthcare in­dus­try in gen­eral, wherein fee-for-ser­vice pay­ment cre­ates dis­in­cen­tives for shar­ing of health in­for­ma­tion and re­wards in­for­ma­tion hoard­ing, or at least the de­lay of timely in­for­ma­tion ex­changes.”

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