April 9, 2010 - Advocacy Corner

Potential Delays in Certification Among CHIME Concerns. In comments filed yesterday in response to the ONC Proposed Rule for Temporary Certification Programs for Health Information Technology, CHIME indicated that the introduction of a two-stage approach—separate temporary and permanent programs--could prolong the current instability in the health IT marketplace. Certifying clinical technology quickly, yet thoroughly, is essential so that providers can implement applications in preparation for meaningful use of EHR technology and stimulus funding.

While supporting the general concept of a two-stage approach for certification of electronic health records, CHIME observed that a two-stage process carried a risk of continuing the uncertainty and promoting needless product replacement in the marketplace. Above all else, providers need a stable marketplace in which vendors can quickly offer and support implementation of certified products.

Other top concerns included making changes in certification requirements only when they are necessary to meet meaningful use evolution or advances in interoperability, rather than for other reasons such as passage of time. For certification of individual EHR modules, there must be an assurance they can communicate according to adopted standards and that the interoperability of those modules as used by providers be deemed as certified.

Permanent certification, the second component of the proposed rule, describes the creation of multiple certifying bodies as well as separate entities by testing laboratories to be accredited by NIST. ONC estimates it would take 6 to 9 months to establish these structures. CHIME is currently developing comments on the permanent program, which is due May 10. For further details and text of the NPRM Temporary and Permanent Certification Program, click here.

HITECH Implementation in Acceleration Mode. Twice this week, Dr. David Blumenthal issued public reports on ONC initiatives to operationalize the vision for nationwide, interoperable health IT. Mayo Clinic of Medicine, Harvard University, University of Texas Health Science Center at Houston, and University of Illinois at Urbana-Champaign were awarded research grants totaling $60 million through the Strategic Health IT Advanced Research Projects (SHARP) program. The SHARP program recognizes the importance of research to support improvements in the quality, safety, and efficiency of healthcare by creating “breakthrough” advances in information technology.

Focusing on states, ONC awarded $267 million to 28 non-profit organizations to establish Health IT Regional Extension Centers (RECs) in this second round of state funding. RECs enable healthcare practitioners to reach out to a local resource for technical assistance, guidance, and information on best practices. These centers are designed to address unique community requirements by assisting physicians in efforts to become meaningful users of electronic health records. As currently structured, RECs are not intended to provide assistance to hospitals.

Also this week, ONC rolled out the Federal Health IT Strategic Plan, which outlines objectives, milestones and metrics related to health information exchange, privacy and security, EHR utilization, reduction of health disparities and other details. The Plan spans the time period of 2011 through 2015. During the public listening session on Tuesday, ONC staff responded to questions on engaging consumers, recognition of the role of payers and a focus on prevention, among others. Comments are posted on the ONC Blog. Next steps include review of public comment by the HIT Policy Committee Strategic Plan Workgroup when it meets April 16 with recommendations to the full HIT Policy Committee meeting the following week.

EP Eligibility and Legislative Fixes. As reported in past issues of the Advocacy Corner, various legislative efforts have sought to address meaningful use incentives for hospital-based physicians who practice in outpatient settings. The House has passed such legislation, while the Senate has yet to do so. Recent conversations with Congressional staff on both sides of the aisle are very encouraging. There appears to be a good understanding of the issue. Bipartisan “Dear Colleague” letters signed by both House and Senate members and direct communications from hospitals have been effective in building the case for a legislative fix. Adding this provision to “must pass” legislation remains to make this a reality.