Robert D. Belfort, Manatt, Phelps & Phillips, LLP, Project HealthDesign Regulatory and Assurance Advisory Group
On March 6, 2013, the U.S. Department of Health and Human Services (HHS) issued a news release announcing its 2013 agenda to bring down costs and improve quality of care through implementation of health information technology. Specifically, the new release introduced HHS’s latest plan to “accelerate health information exchange (HIE) and build a seamless and secure flow of information essential to transforming the health care system.” In the release, HHS indicated it will, among other things:
- Set aggressive goals for 2013: HHS is setting the goal of having 50 percent of physician offices using electronic health records (EHRs) and 80 percent of eligible hospitals receiving meaningful use incentive payments by the end of 2013.
- Increase the emphasis on interoperability: HHS will increase its emphasis on ensuring electronic exchange across providers. It has started that effort by issuing a request for information (RFI) seeking public input about a variety of policies that will strengthen the business case for electronic exchange across providers to ensure patients’ health information will follow them seamlessly and securely wherever they access care.
- Enhance the effective use of electronic health records through initiatives like the Blue Button initiative. Medicare beneficiaries can access their full Medicare records online today. HHS is working with the Veterans Administration and more than 450 different organizations to make health care information available to patients and health plan members. HHS is also encouraging Medicare Advantage plans to expand the use of Blue Button to provide beneficiaries with one-click secure access to their health information.
- Implement Meaningful Use Stage 2: HHS is implementing rules that define what data must be able to be exchanged between Health IT systems, including how data will be structured and coded so that providers will have one uniform way to format and securely send data.
In its Request For Information (RFI), HHS requested feedback from the public on various ways to accelerate electronic HIE. One of the RFI’s focus areas is consumer and patient engagement. According to the RFI, “CMS wants to encourage beneficiary engagement in their care through improved beneficiary access to their personal health information and better electronic communication between beneficiaries and their health care team. There are several ways CMS could encourage beneficiary access to their information through the use of new measures or patient-reported care experiences, new technology tools, and new financial models.” The specific options that CMS holds out as examples in the RFI are:
- Incorporating new measures into Medicare Advantage Program consumer assessment surveys (CAHPS);
- Blue Button availability to all CMS beneficiaries;
- Payment and service delivery model testing under the Affordable Care Act, such as demonstration of incentives for consumers to more actively participate in their health; and
- Direct access to lab results from laboratories.
CMS posed the following specific question in the RFI: “What CMS and ONC policies and programs would most impact patient access and use of their electronic health information in the management of their care and health? How should CMS and ONC develop, refine and/or implement policies and program to maximize beneficiary access to their health information and engagement in their care?”
What are the lessons we have learned from Project HealthDesign that should be brought to bear on this question? Post them below or submit comments directly to ONC. The RFI can be accessed here https://www.ofr.gov/OFRUpload/OFRData/2013-05266_PI.pdf