Electronic Health Records

Congress wants meaningful use to address health disparities

Members of Congress are pushing the leaders of the Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) to use the EHR Incentive Programs as a vehicle for eliminating health disparities, according to a joint statement issued by Representatives Lois Capps (D-CA) and Mark Takano (D-CA).

The two Californian Congress members are reiterating the intentions they laid out in a letter late last month signed by themselves and 22 of their colleagues and addressed to CMS Administrator Marilyn Tavenner, MHA, RN, and the National Coordinator Karen DeSalvo, MD, MPH, MSc. In particular, these lawmakers want CMS and ONC to take a long look at the Consumer Partnership for eHealth’s Disparities Action Plan for guidance.

“Health disparities are a pervasive and costly problem,” the letter states. “Through the development of the Stage 3 Meaningful Use criteria, ONC has an immediate opportunity not only to make an extraordinary difference for the millions of patients, families, and caregivers experiencing health disparities, but to improve the quality, safety, and efficiency of America’s health care system as a whole.”

The lawmakers have provided four recommendations that they believe would help achieve this end:

1. Improve data collection. Meaningful Use should adopt more comprehensive and inclusive standards of data collection developed by HHS, similar to what the Census uses, in order to better recognize, track, understand and reduce disparities, including collection of disability status, sexual orientation and gender identity variables.

2. Improve data use. Data collected by EHRs should stratify patients’ health status by disparity in order to facilitate improvements in care and health status among these vulnerable populations.

3. Improve health literacy and communication. EHR software should have the functionality to enable providers to improve health literacy and communication. This can be done by displaying communications for patients at a reading level no higher than sixth to eighth grade level, use common terminology rather than medical jargon whenever possible and be accessible to those with visual, hearing, cognitive and communication impairments.

4. Improve access. Smartphones can provide critical access to health information and health care in underserved communities. Many underserved populations rely on smartphones instead of computers. Consequently, Meaningful Use should ensure that patients can access their own health information through mobile platforms.

While CMS and ONC share many responsibilities for determining the direction of meaningful use, their respective control of the programs is unique. ONC handles the certification criteria for EHR technology that must be used to achieve meaningful use while CMS determines the measures and thresholds eligible hospitals and professionals must achieve in order to demonstrate meaningful use and receive incentives or avoid penalties.

The Congress members, however, appear to be placing the onus squarely on the shoulders of the ONC. “Breakthroughs in health information technology and improved data collection in the ‘meaningful use’ guidelines can be a powerful tool to improve healthcare for all Americans, and I urge the ONC to make the constructive changes we have identified,” Rep. Takano said in a public statement.

The criteria for Stage 3 Meaningful Use are currently under development and the proposed rule isn’t expected until the fall.

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