Deven McGraw, Project HealthDesign Regulatory and Assurance Advisory Group, Center for Democracy & Technology
Usually in the weeks before a presidential election, Congress is officially in recess; many elected officials are in their home districts or states campaigning for re-election (and also weighing in on the presidential race); and typically there are few congressional developments worth noting.
But this year has been a bit of an exception – at least for those of us who follow health reform and health information technology issues. This week, a group of Republican members of Congress and Republican senators sent letters to HHS Secretary Kathleen Sebelius raising serious concerns about the Meaningful Use electronic medical record incentive program.
The letter from key House Republicans – Rep. Dave Camp (R-MI), Chairman of the House Ways & Means Committee, and Rep. Wally Herger (R-CA), Chairman of that Committee’s Subcommittee on Health; and Rep. Fred Upton (R-MI), Chairman of the House Energy & Commerce Committee, and Rep. Joe Pitts, Chairman of that Committee’s Subcommittee on Health (R-PA) – raises “serious concerns” that the Stage 2 final rules for Meaningful Use are too weak. Specifically, the letter points out that the requirements for exchange of clinical health information among health care professionals, such as to support transitions in care, are very low.
The letter from key Senate Republicans – Sens. John Thune (R-SD) and Tom Coburn (R-OK) of the Senate Finance Committee, and Sens. Richard Burr (R-NC) and Pat Roberts (R-KS) of the Senate Health, Education, Labor and Pensions Committee – stresses concerns about EHR use causing increased utilization of, and billing for, health care services. The letter from House Republicans also notes this concern. Both letters also raise concerns about the lack of interoperability among EHRs.
The letter from Senate Republicans requests an extended briefing with administration officials to hear their responses to the concerns in the letter. In contrast, the letter from House Republicans urges Secretary Sebelius to “immediately suspend the distribution of [EMR] incentive payments until your agency promulgates universal interoperable standards;” to “significantly increase” the Stage 2 Meaningful Use objectives; and to “take steps to eliminate the subsidization of business practices that block the exchange of information between providers.”
Are these letters just typical election year politics? The issues raised in both letters echo concerns raised by other stakeholders. The signatories to the House Republican letter are the Chairmen of the most important health committees and subcommittees in the House; signatories to the Senate Republican letter are members of the two relevant health committees in that chamber. All who have an interest in the successful implementation of the HITECH EHR incentive program would be well served to monitor these developments closely.