The Senate Committee on Health, Education, Labor and Pensions this week approved a bill(www.help.senate.gov) meant to ease the headache of clumsy health IT systems that demand too much effort for too little benefit.
The Improving Health Information Technology Act(www.help.senate.gov) would establish standards for interoperability, vendor performance and care coordination in health IT systems.
The AAFP offered several recommendations to improve the legislation in a Jan. 29 letter(5 page PDF) to Sens. Lamar Alexander, R-Tenn., and Patty Murray, D.-Wash., the chair and ranking member of the committee, respectively. Previously, (then) AAFP President Robert Wergin, M.D., of Milford, Neb., testified before the committee about difficulties that health IT systems cause physicians.
The Academy has amplified family physicians' criticism of health IT systems that do not allow for sharing of information with other physicians or institutions unless an additional fee is paid. Physicians point out that although they are held accountable for how the technology is used, the vendors that sell the technology are not held accountable for business practices that hinder information-sharing.
- The Senate Committee on Health, Education, Labor and Pensions approved a bill that would establish standards for health information systems.
- Health IT systems would be evaluated on their ability to share information and help physicians coordinate care, as well as vendor performance.
- The AAFP offered several suggestions for improving the bill in previous testimony and a recent letter.
"System interoperability, which is the ability to share and utilize information between two or more information systems, is critical in today's health care environment," the AAFP said in its letter. "Yet significant challenges continue to impede true information reciprocity across the spectrum of care."
The bill directs HHS to create standards for information exchange among IT vendors. If enacted, the agency also would be tasked with spelling out what actions constitute information blocking and authorizing the Office of the Inspector General to investigate allegations of such practices.
Legislators also included language that would set standards for health IT vendors by establishing specific performance areas they would be graded on.
Currently, such grading would be difficult because many contracts prohibit physicians from commenting about their health IT vendors. The legislation would increase transparency by creating a council to rate health IT companies, which would include members from primary care and subspecialties.
The AAFP urged senators to establish a five-star rating system for health IT vendors and to include public health officials and state IT specialists on the council.
"Establishing a quality rating system should provide as much information as possible and distinguish clearly between strong and poor performers," the letter stated.
Under the bill, health IT systems would be evaluated on their ability to access state health registries and other public health data registries. The AAFP said such evaluations should rate systems on their ability to enable care coordination and facilitate clinical decision-making. Too often, electronic records contain numerous pages of data that are irrelevant to patient care.
"The ability to interface with public health data registries is essential for primary care physicians," said the letter. "Standards that require efficient clinical decision-making have tremendous potential to improve usability for physicians and to promote patient health and safety. Unfortunately, this is a serious flaw in many electronic health record systems."
The bill also states that patients should be able to receive their complete health profile from an electronic record. The AAFP supports the provision but stated in its letter that the requirement should focus on clinical health information rather than on billing details, which are extensive and often confusing to patients.
The AAFP also expressed concern about providing unique patient information to individuals or institutions that are not subject to privacy regulations.
"We need new approaches, such as a strategy for patient identifiers so consumers can be safely and efficiently added to a trusted exchange," said the letter.
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