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Will Senate Bill Help to End the EHR Incentive Programs?

According to John Halamka, the new Senate HELP Committee draft legislation could be the key to improving the EHR Incentive Programs.

By Sara Heath

The Senate Health Committee’s recent draft legislation may contribute to the end of the EHR Incentive Programs, says John D. Halamka, MD, CIO of Beth Israel Deaconess Medical Center.

In the midst of industry confusion surrounding the fate of the meaningful use program, Halamka offered his two cents, saying that the draft legislation recently released by the Senate Health Education Labor and Pensions (HELP) Committee could be the key to fixing the EHR Incentive Programs.

The draft legislation includes provisions to reduce superfluous physician documentation, increasing patient access to health records, and making health records accessible to all healthcare professionals, especially nurses.

These changes are just what the industry needs to help reform the meaningful use programs, Halamka says.

“Providing a path for hospitals requires new legislation,” Halamka explains. “The HELP Committee draft legislation may provide that path.”

Specifically, Halamka says that the HELP Committee’s call for one HIT Policy and Standards Committee, which is a major provision in the draft legislation, makes sense for creating more effective policies.

“Policy and technology are two sides of the same coin. Interoperability requires technology standards supported by governance and data use agreements,” the CIO writes. “In the past, the Policy Committee and the Standards Committee worked using a waterfall methodology - policies were created and then standards advice was requested. The notion of one group, chartered to produce policy and technology in parallel, makes sense.”

The only part of the draft legislation that Halamka does not entirely agree with is the call for a health IT ratings system, referring to it as a “Yelp”-like rating system that no other government industry has. Instead, these kinds of ratings should be left to private, industry stakeholder research groups who are best-equipped with releasing industry reports.

“A better approach is for private companies, such as KLAS to provide the research the market demands,” he says.

Much of this discussion of the future of ERH program policies and standards has been sparked by an announcement by CMS Acting Administrator Andy Slavitt, recently delivered at the JP Morgan Healthcare Conference. At the conference, Slavitt remarked that the agency planned to end meaningful use as we know it.

Instead, Slavitt explained that the program would take a more physician- and patient-centric approach, putting physicians in charge of the care outcomes they wish to achieve through the use of their EHRs. CMS would then be in charge of rewarding them for those outcomes-based goals.

However, shortly after making that statement, Slavitt, in conjunction with Karen DeSalvo of the Department of Health and Human Services, authored a blog post saying that meaningful use was still going strong. Because of legislative restrictions, the agencies could not quickly and easily repeal the already existing program.

Halamka offers his own thoughts on the situation, saying that perhaps Slavitt is something of an outsider at CMS who individually wants to see an end to the meaningful use program.

“Andy Slavitt is outsider at CMS.  He was being was being very genuine when he said that Meaningful Use has run its course based on what he has heard from stakeholders,” Halamka says.

“However, there are folks at CMS who want the current path of Meaningful Use to continue,” Halamka continues. “Also, there are current laws on the books that make change difficult - ARRA/HITECH still applies to hospitals.”

The CIO concludes by saying that he will be keeping a close eye out for progress in the HELP Committee legislation, as he sees it as a very important piece of legislation due to its potential to make significant changes to meaningful use.

“I will watch this draft bill very closely,” he concludes. “I’m hopeful that Congress will give Andy Slavitt the support he needs to end Meaningful Use as we know it."




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