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Doc Fix Deal Sets 2017 Deadline for Health IT Systems That Easily Exchange Health Data

By John Reichard, CQ HealthBeat Associate Editor

February 7, 2014 -- The legislation announced last week to overhaul the Medicare physician payment formula also sets a goal of establishing health information technology systems that freely exchange medical data among different provider systems by 2017.

Champions of speedier action on "interoperability," widely viewed as crucial to fulfilling the potential of health IT to save money and reduce medical errors, hailed the language, although it falls short of establishing a hard deadline.

"Congress declares it a national objective to achieve widespread exchange of health information through interoperable certified Electronic Health Record technology nationwide by December 31, 2017," the bill's (HR 4015) language states.

The deadline dovetails with the timetable for the establishment by physicians of new payment and delivery models to get deliver higher quality, efficient treatment to Medicare patients.

"We are particularly pleased the bill sets interoperability as a national goal and creates a roadmap for achieving interoperability by the time new payment and delivery models are required in Medicare in 2017," said Joel White, executive director of the Health IT Now coalition, which includes vendors and employers, among other members.

Interoperability is one of the standards for so-called "meaningful use" of health information technology that hospitals and doctors must make to qualify for higher Medicare and Medicaid payments. But the coalition, patient advocacy groups, and some Republicans on Capitol Hill say progress toward interoperability is too slow under the meaningful use program.

On the other side of the issue are providers, who say they already stretched thin by the demands of the meaningful use program and its pace of standard setting.

White said in an email message that "there is no deadline for interoperability in current law."

The bill would require the Heath and Human Services Department (HHS) secretary to establish metrics by no later than July 1, 2015, to determine whether the goal of widespread interoperability of health IT systems by Dec. 31, 2017, has been met. Those metrics do not now exist, White said.

There are no immediate penalties if systems aren't interoperable by 2018. However, if the HHS secretary determines that widespread interoperability hasn't been established by the end of 2017, then he or she must submit a report to Congress by the end of 2018 identifying barriers to meeting the goal. The report also must make recommendations that lawmakers can take to meet the goal such as adjusting Medicare payments and recommending the decertification of electronic health records as ineligible for those payments.

The bill also aims to prevent providers from blocking access by other providers to their medical data through "a process specified by the Secretary" such as attestation that the provider "has not knowingly and willfully taken any action to limit or restrict the compatibility or interoperability of the certified [electronic health record] technology." The anti-blocking provisions would take effect on the date one year after the legislation becomes law.

Among other provisions the bill also aims to create a website allowing providers to compare how well various electronic health record products work. The HHS secretary would have to complete a report on the feasibility of such a site within one year of the enactment of the bill.

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