Electronic Health Records

Policy & Regulation News

Star Ratings Proposed for Electronic Health Records

By Frank Irving

- A new bill proposed by Senators Bill Cassidy (R-LA) and Sheldon Whitehouse (D-RI) would lend customer-facing support to healthcare organizations selecting an electronic health records system. A health information technology rating program is embedded in Senate bill 2141, submitted as the Transparent Ratings on Usability and Security to Transform Information Technology Act of 2015 (TRUST IT Act).

Senators Bill Cassidy and Sheldon Whitehouse have proposed legislation that would enable technology ratings for EHR systems.

The bill calls for a development council to establish a star-based rating program to evaluate “the field performance of certified health information technology with regard to interoperability, usability and security.” Three stars would signify excellence; two stars, satisfactory performance; and one star, less than satisfactory performance.

The development council would include one representative from each of the accredited HIT certifying bodies and testing laboratories, and one representative from the Office of the National Coordinator for Health IT (ONC). If the bill becomes law, the council would set up reporting criteria within a year after enactment.

The bill proposes the following reporting categories for the technology under evaluation:

  • security;
  • usability and user-centered design;
  • interoperability;
  • conformance to certification testing; and
  • “other categories as appropriate to measure the performance of health information technology.”

Specific measures may include:

1) Enabling the user to order and view the results of laboratory tests, imaging tests and other diagnostic tests.

2) Submitting, editing and retrieving data from registries for quality of care.

3) Accessing and exchanging information and data from medical devices.

4) Accessing and exchanging information and data held by federal, state and local agencies and other applicable entities useful to a care provider or other applicable user in the furtherance of patient care.

5) Accessing and exchanging information from other healthcare providers or applicable users.

6) Accessing and exchanging patient-generated information.

7) Providing the patient with a complete copy of his or her electronic record in a computable format.

8) “Other appropriate functionalities.”

The bill further stipulates that small and start-up vendors should not be “unduly disadvantaged by the reporting criteria or rating scale methodology.

A 60-day comment period would allow for public feedback on the reporting criteria and methodology prior to issuance of a final rule.

The star rating for each certified health information technology would be published on ONC’s website, along with the methodology.

Vendors rated at one star would be subject to a corrective action plan within a timeframe designated by the Health and Human Services (HHS) Secretary. Failure to improve from one-star status within the timeframe could result in decertification of the technology.

Vendor fines would also be in play. In setting fines, the HHS Secretary would consider “amounts necessary to reimburse, in part or in full, the users of decertified health information technology for the amounts invested in purchasing new certified health information technology.”

Overall, vendors would be required to report on the assessment criteria every two years. The Government Accountability Office would report every four years on the appropriateness of the rating scale methodology.

Cassidy, a physician, released a public statement in conjunction with the bill, saying it would enable doctors “to better care for their patients and, in turn, deliver on the promise that their information is being used for their benefit and not for the benefit of others.”

The bill has been read twice in the Senate and has been referred to the Committee on Health, Education, Labor & Pensions (HELP), of which both Cassidy and Whitehouse are members.

Click here for a recap of the HELP Committee’s most recent hearing on health IT.





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