Today, HHS’ Centers for Medicare & Medicaid Services and HHS’ Office of the National Coordinator for Health IT released final requirements for stage 2 that hospitals and health care providers must meet in order to qualify for incentives during the second stage of the program, and criteria that electronic health records must meet to achieve certification.
The requirements announced today:
• Make clear that stage two of the program will begin as early as 2014. No providers will be required to follow the Stage 2 requirements outlined today before 2014.
• Outline the certification criteria for the certification of EHR technology, so eligible professionals and hospitals may be assured that the systems they use will work, help them meaningfully use health information technology, and qualify for incentive payments.
• Modify the certification program to cut red tape and make the certification process more efficient.
• Allow current “2011 Edition Certified EHR Technology” to be used until 2014.
For Milliman’s perspective on electronic health records, click here.
Jim Schibanoff, Editor-in-Chief of Milliman Care Guidelines; Ron Sims, King County Executive; and Mike Kreidler, Washington State Insurance Commissioner, give their final thoughts at Healthcare Town Hall.
Q: We just have a few minutes left. I’d like to use them to ask you to think for a moment: Is there anything here that you think is important to say about electronic health records that didn’t get said or any final thought you’d like to leave our audience with here in the hall and on TVW?
Jim Schibanoff: Well, I don’t think we’ve touched on the research potential of the electronic health record databases. At huge institutions like Kaiser and the VA, they use EHR as a research tool to look for things like complications of drugs. The best example is, there was this new pain medicine, COX-2, C-O-X 2, that replaced a pain medicine that caused intestinal bleeding. So these COX-2 inhibitors were the great development in pain relief. At Kaiser, they found that, with their very large databases, they found that COX-2 inhibitors caused heart attacks, and most of them were taken off the market. And it was through the power of these very large databases that they became a tremendous research tool, and I think this whole field holds great promise for our research frontier.
Mike Kreidler, John Hammarlund, George Scriban, Scott Armstrong, and Ron Sims discuss EHR as a catalyst for healthcare reform, responding to a question submitted by Cody Augdahl.
For submitting this question, Cody Augdahl is a finalist in our question contest. Congratulations, Cody.
Q: I have another question that came from someone who submitted one before the event; it was submitted via e-mail. It’s kind of an interesting question. It asks us to imagine the day when, in fact, a majority of the U.S. population has adopted personally controlled health records. What kind of impact would that have more broadly on the system potentially, do you think? I mean, it’s a little bit hard to put ourselves out there and imagine the circumstance, Mike, but could you see how that might be a catalyst for other change?
Mike Kreidler: I think you need a great deal more transparency in the system than you have right now, and that’s one of the real problems. You can’t even do any accounting in the system right now because of the variation that you have.
Will Fox, Principal and Consulting Actuary at Milliman; Scott Armstrong, Group Health CEO; Joe Scherger, MD, Consulting Medical Director at Lumetra; and John Hammarlund, Regional Administrator for the Centers of Medicare and Medicaid Services, all address this question.
Q: Where is the return on the investment for the patient’s pocketbook resulting from the savings involved in health care information systems and electronic health records? When can patients see some tangible, monetary benefits themselves? We’ve talked about benefits to the providers and so forth, what about the patient?
Will Fox: I think that’s a big key. How often, if ever at this point, are patients told what these things are going to cost? When they get an X-ray for back pain, do they know how much it costs?
Joe Scherger, MD, Consulting Medical Director, Lumetra, discusses how EHR can change care delivery.
Barry: Joe Scherger, we were talking earlier about your experience with healthcare informatics, which suggests to me that maybe just talking about records may not get fully at the potential benefits that the electronic age presents for improvement of care. Talk about that.
Joe Scherger, MD: No, Barry, I’m most excited about the fact that we’re on the cusp of a whole new way of healthcare delivery. Electronic records in the
Scott Armstrong, Group Health CEO, addresses this question.
Barry: What can electronic health records do for us? Scott Armstrong at Group Health, I understand that you’ve been using electronic records for some time. How’s it going?
Scott Armstrong: Well, thanks, Barry. We, as you said, we have been using electronic records in our care delivery system for more than four years now. This is thousands of terminals in our medical centers all across the state.
Rich Moyer, MedInsight Project Manager; Gail Graham, Veterans Health Administration Director of Health Data and Informatics; Ron Sims, King County Executive; and Scott Armstrong, Group Health CEO, address this question as panelists at Healthcare Town Hall.
Barry: I have a question from the audience, and Rich, maybe you could take this. Question is, “I remember a panel some years ago being as optimistic about electronic voting as this panel is about electronic health records. Electronic voting has mostly been discredited for various reasons. What might be the pitfalls, Rich, in electronic health records? Are electronic health records kind of the personal jet-pack of the 21st Century?”
Rich Moyer: You know, I think the privacy concerns are foremost, and the question about control of the data and what people are using it for. You know, I think that’s the downside. I think, though, that looking at the model of the financial industry where you do have access, and you’re able, and it’s data from all over the place, and they don’t have interoperability between all financial services, and the ability to take that and make use of it, and to use whatever tools on that data, I think, far outweighs the issue. I think we’ll have electronic health records way before we have electronic voting for good or bad.
Scott Armstrong, Group Health CEO; Rich Moyer, MedInsight Project Manager; George Scriban, Microsoft HealthVault Senior Global Strategist; Ron Sims, King County Executive; John Hammarlund, Regional Administrator for Centers for Medicare & Medicaid Services; and Gail Graham, Veterans Health Administration Director of Health Data and Informatics, address this question as panelists at Healthcare Town Hall.
Barry: It would seem that having consumers have exclusive or primary control over the records and portability, therefore, would eliminate incentives for healthcare providers to invest in record systems insofar as it’s going to liberate the customer to go wherever. So the question is, is that a tension for you as a provider, a disincentive for you as a provider?
Scott Armstrong: I don’t really care who owns the data. You know, this data, I think, and these systems, are going to be ubiquitous in, I don’t know, six, eight, ten years, and that this discussion right now about who controls the data I think is just really a short-lived discussion.