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Senators Signal Interest in Electronic Health Records Changes

By Melanie Zanona, CQ Roll Call

October 1, 2015 -- Obama administration officials told a Senate panel that Congress can help improve the use of electronic health records through potential provisions in the committee's upcoming biomedical innovation bill. But officials were reluctant to endorse a delay in requirements under a federal program meant to encourage the records' adoption–a postponement favored by top lawmakers on the panel.

In the last string of Senate Health, Education, Labor, and Pensions hearings to identify "five or six steps" to enhance health information technology, Chairman Lamar Alexander said Thursday that he hopes to include some of the committee's findings in a bipartisan package to speed new medical cures. The House passed its own version (HR 6) in July and the committee is expected to release its first draft in coming weeks.

"We want to do in our legislation what the administration can't do administratively," Alexander said. The Tennessee Republican previously had said the issue might not need to be addressed legislatively.

The committee is exploring ways to increase interoperability, or getting electronic health information systems to talk to each other. The so-called meaningful use program, a $30 billion Centers for Medicare and Medicaid Services program included in the 2009 stimulus package (PL 111-5), was meant to incentivize doctors and hospitals to adopt electronic health records, or EHRs. But physicians and other providers have struggled to meet the first two phases of requirements.

"In the same way that an email sent from a Gmail account makes sense when it's opened in Yahoo, data in one EHR system should be structured so that it makes sense in others," said Patty Murray of Washington, the panel's ranking Democrat.

Health and Human Services Department Acting Assistant Secretary for Health Karen DeSalvo outlined efforts the administration is already taking to make health IT more effective, such as expanding alternative payment models, simplifying program requirements, and collaborating with the private sector.

But she suggested that the committee also could assist by prohibiting systems from intentionally blocking data from one another, improving transparency in the marketplace and establishing a mechanism to hold vendors more accountable.

"We share the goal of making this technology more usable, and should Congress choose to legislate in this area, these actions could further help health IT reach its full potential," DeSalvo said.

Bill Cassidy, R-La., announced at the hearing that he would introduce legislation next week with Sheldon Whitehouse, D-R.I., aimed at enhancing interoperability. A Cassidy aide said they hope it will be folded into the panel's biomedical innovation package. The House version included language affecting the issue.

One area that was not addressed in the House bill was delaying the next phase of upcoming meaningful use requirements that dictate what criteria providers must meet  to receive payments and avoid penalties. 

Alexander expressed concern that the administration would "rush" to move forward with finalizing the third stage of regulations this fall when only 12 percent of physicians and 40 percent of hospitals have been able to comply with the second stage requirements. Alexander urged administration officials to take more time to "get it right" and warned that Congress could step in if necessary.

"We have an opportunity in Congress to carefully review whatever decision the administration makes about how we proceed," Alexander said. "One way can do that is through the innovation legislation."

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