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Administration Sets Benchmarks for Health IT Changes

By Rebecca Adams, CQ Roll Call

January 30, 2015—The Obama administration wants all medical providers and even consumers to be able to send, receive, and use electronic medical records with a nationally universal set of data—such as a patient's name, smoking status, medications, and health history, among other things—by the end of 2017. 

The goal was included in a 166-page roadmap that the Department of Health and Human Services (HHS) released late last week. HHS' Office of the National Coordinator for Health Information Technology also released a draft advisory on interoperability. Both are open to comments from the public.

The documents tie in with two other initiatives that HHS officials focused on this week: President Barack Obama's initiative to encourage personalized medicine and efforts to encourage providers to coordinate on patients' care through new Medicare payment models. Karen DeSalvo, the national coordinator for health IT, called the efforts a "three-pronged plug" that will help medical professionals sort through and use information about their patients.

The ability to share electronic health data among providers helps achieve goals in the other areas. The most efficient way for medical providers to coordinate and tailor their patients' care is by using medical records that can be easily shared electronically.

The roadmap and interoperability standards build on a framework that the Office of the National Coordinator put out in June. DeSalvo said on a call with reporters that with the flurry of activity around electronic health records, "the time has come for us to be more explicit about standards."

Federal officials will be focused on putting encouraging medical professionals to build onto their electronic capabilities so they can share data.

"We are considering our regulatory options and considering how we can leverage certification to ensure accountability with rules of road," said Jodi Daniel, director of the Office of Policy in the Office of the National Coordinator, on the call.

The administration is working on a rule that will be released soon on certification and is evaluating other regulatory and certification program options.

The interoperability standards that HHS has released will be updated annually.

The administration plans to enhance incentives, through grants and other opportunities, for sharing electronic health information according to common technical standards, starting with a common set of facts about each patient's health history and information.

Federal officials also said that they would try to knock down confusion or gaps in providers' and the public's knowledge about federal privacy laws such as the 1996 Health Insurance Portability and Accountability Act, known as HIPAA (PL  104-191).

"Many organizations have misinterpreted HIPAA rules and other regulations and therefore refrain from sharing health information, even with individuals themselves," said the roadmap.

"To realize better care and the vision of a learning health system, we will work together across the public and private sectors to clearly define standards, motivate their use through clear incentives, and establish trust in the health IT ecosystem through defining the rules of engagement," said DeSalvo. 

The announcement came a day after HHS officials acknowledged concerns of the health care industry about so-called meaningful use requirements, which ultimately cut Medicare payments to providers who do not adopt electronic medical records. The administration said CMS is considering proposals to realign hospitals' electronic health record reporting periods to the calendar year to allow more time to incorporate 2014 edition software into workflows, and to shorten the reporting period in 2015 to 90 days. 

A number of business leaders praised the roadmap and new standards.

"The benefits to patients and to the future of American health care in achieving full interoperability are enormous," said Mary R. Grealy, president, Healthcare Leadership Council. "We applaud HHS and the Office of the National Coordinator for making interoperability a national priority and we believe that, by bringing together the ideas and technological expertise from both the public and private sectors, it is a foreseeable and achievable goal.

When DeSalvo was asked on the call whether providers' systems will soon be able to "talk" to each other and share information, she sounded optimistic.

"The truth is that today, it does happen in this country" already, she said. "Communities all across this country have shown us the way."

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