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HHS Officials Say They'll Accelerate Exchange of Health Data Among Providers

By John Reichard, CQ HealthBeat Editor

March 6, 2013 -- The top official in charge of Medicare and Medicaid and the head of the federal health information technology office recently said they'll step up efforts to promote the computerized exchange of patient data among the various providers in the health system.

Despite the growing adoption of electronic medical records, that kind of information sharing is moving too slowly to make good on the promise of health information technology to cut care costs and improve patient safety and quality of care, critics say.

But Centers for Medicare and Medicaid Services (CMS) Acting Administrator Marilyn Tavenner said in a news release last week that "health IT and the secure exchange of information across providers are crucial to reforming the system, and must be a routine part of care delivery."

Farzad Mostashari, the National Coordinator for Health Information Technology, announced a "request for information" to invite comment on how to speed up information exchange. "We are interested in hearing about policies that could provide an even greater business case for such information sharing," he said.

Tavenner and Mostashari were scheduled to speak at a meeting in New Orleans sponsored by the Health Information and Management Systems Society.

Payment systems that reward providers for lowering costs and improving quality are expected to speed the pace of sharing lab results, medical imaging, prescription drug use summaries, and other clinical data, to avoid wasteful duplication of tests and treatments and ward off medical errors. But the current fee-for-service system lacks such incentives, the new request for information says.

"Both providers and their vendors do not yet have a business imperative to share person level health information across providers and settings of care," the request acknowledges.

It notes, for example, that only one of every four hospitals in 2011 "could exchange medication lists and clinical summaries with outside providers." And that year only 31 percent of doctors were exchanging clinical summaries with other providers.

CMS and the Office of the National Coordinator are using incentive payments to foster information exchange through the use of health IT and the certification of health IT systems. But in addition to those programs, Health and Human Services says in the notice that it intends "to rely on all applicable and appropriate statutory authorities, regulations, policies, and programs to accelerate rapid adoption of health information exchange across the care continuum."

The notice mentions ways in which the department might seek to spur more exchange of information. It says, for example, that "HHS can collaborate in the development of new e-specified measures of care coordination that encourage electronic sharing of summary records following transitions ins care." CMS "might consider new ways to require or encourage Medicare accountable care organizations to exchange health information," it adds.

The officials also announced a goal of having 50 percent of doctors' offices using electronic health records by the end of 2013 and 80 percent of eligible hospitals receiving "meaningful use" incentive payments by that time. They also said they aim to spur greater use of what they call the "Blue Button," an electronic way Medicare beneficiaries can now access their full Medicare records online. And to make sure that providers aren't using health IT to "upcode" and bill for more extensive services they are providing, they said HHS is "conducting extensive medical reviews and issuing comparative billing reports that identify providers."

Tavenner said in a speech earlier this week that "what we'll do is spend 2013 pausing and reflecting on these areas to try and increase the education, make sure we have the vendors on board, make sure we do some small targeted audits."

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