HHS is effectively taking a "time out" in its rule-making process to ponder the best way to move forward with stage three of electronic health record (EHR) meaningful use objectives intended to improve the quality, safety and efficiency of health care.
According to a notice in the March 7 Federal Register(www.federalregister.gov), HHS "recognizes the need to use evidence and data on provider behavior to inform ongoing policy development that will result in a connected, person-centric health care system where health information is routinely shared across providers and settings of care."
To that end, HHS is seeking input on potential options to accelerate the existing progress of EHR adoption throughout the U.S. health care system. The agency is asking for outside comment on its ideas and also invites physicians and other stakeholders to offer additional options that they think can be effective in meeting the agency's goals.
Specifically, HHS details policies and programs it is considering that deal with the development of health information technology and EHRs that would address the current
- low rates of EHR adoption and use of health information exchanges (HIEs) among post-acute and long-term care professionals,
- low usage of HIEs across settings of health care and health care professionals, and
- low levels of consumer and patient engagement.
The AAFP recently sent a letter to the ONC, asking for a delay in implementation of meaningful use stage three requirements until at least 2017 and an enforcement delay or elimination of all penalty provisions. "We remain concerned that HHS is attempting to raise the bar for what constitutes meaningful use before the majority of physicians and hospitals are able to achieve the meaningful use stage one or two objectives," said the letter from AAFP Board Chair Glen Stream, M.D., M.B.I., of Spokane, Wash.
In its request for information, HHS also lists questions on which CMS and the Office of the National Coordinator for Health IT (ONC) are soliciting comments. Family physicians likely have strong opinions on some of the topics. For example, federal authorities ask for physician input on
- what changes in payment policy would most affect the electronic exchange of health information;
- the extent to which current CMS payment policies encourage or impede the exchange of electronic information across health care provider organizations;
- how HHS' EHR incentive programs could best facilitate the creation of health care provider "directories" that would support the exchange of health information among participating physicians;
- ways to efficiently test, evaluate and scale payment- and service-delivery models to accelerate standards-based electronic exchange of health information;
- the policies and programs that HHS and ONC should continue, refine or develop to maximize patients' access to their health information and engagement in their health care; and
- specific HHS policy changes that would escalate the electronic exchange of lab results.
Comments to HHS must be received no later than April 22 at 5 p.m. EDT. Comments may be submitted via the federal e-rulemaking portal(www.regulations.gov); by regular mail sent to HHS' Office of the National Coordinator at the Hubert H. Humphrey Building, Suite 729D, 200 Independence Ave., S.W., Washington, 20201; or by hand delivery to the same address.