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AHA Asks Congress To Reduce Health IT Regulations for Medicare Providers

Posted on September 22, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

The American Hospital Association has sent a letter to Congress asking members to reduce regulatory burdens for Medicare providers, including mandates affecting a wide range of health IT services.

The letter, which is addressed to the House Ways and Means Health subcommittee, notes that in 2016, CMS and other HHS agencies released 49 rules impacting hospitals and health systems, which make up nearly 24,000 pages of text.

“In addition to the sheer volume, the scope of changes required by the new regulations is beginning to outstrip the field’s ability to absorb them,” says the letter, which was signed by Thomas Nickels, executive vice president of government relations and public policy for the AHA. The letter came with a list of specific changes AHA is proposing.

Proposals of potential interest to health IT leaders include the following. The AHA is asking Congress to:

  • Expand Medicare coverage of telehealth to patients outside of rural areas and expand the types of technology that can be used. It also suggests that CMS should automatically reimburse for Medicare-covered services when delivered via telehealth unless there’s an individual exception.
  • Remove HIPAA barriers to sharing patient medical information with providers that don’t have a direct relationship with that patient, in the interests of improving care coordination and outcomes in a clinically-integrated setting.
  • Cancel Stage 3 of the Meaningful Use program, institute a 90-day reporting period for future program years and eliminate the all-or-nothing approach to compliance.
  • Suspend eCQM reporting requirements, given how difficult it is at present to pull outside data into certified EHRs for quality reporting.
  • Remove requirements that hospitals attest that they have bought technology which supports health data interoperability, as well as that they responded quickly and in good faith to requests for exchange with others. At present, hospitals could face penalties for technical issues outside their control.
  • Refocus the ONC to address a narrower scope of issues, largely EMR standards and certification, including testing products to assure health data interoperability.

I am actually somewhat surprised to say that these proposals seem to be largely reasonable. Typically, when they’re developed by trade groups, they tend to be a bit too stacked in favor of that group’s subgroup of concerns. (By the way, I’m not taking a position on the rest of the regulatory ideas the AHA put forth.)

For example, expanding Medicare telehealth coverage seems prudent. Given their age, level of chronic illness and attendant mobility issues, telehealth could potentially do great things for Medicare beneficiaries.

Though it should be done carefully, tweaking HIPAA rules to address the realities of clinical integration could be a good thing. Certainly, no one is suggesting that we ought to throw the rulebook out the window, it probably makes sense to square it with today’s clinical realities.

Also, the idea of torquing down MU 3 makes some sense to me as well, given the uncertainties around the entirety of MU. I don’t know if limiting future reporting to 90-day intervals is wise, but I wouldn’t take it off of the table.

In other words, despite spending much of my career ripping apart trade groups’ legislative proposals, I find myself in the unusual position of supporting the majority of the ones I list above. I hope Congress gives these suggestions some serious consideration.

Data Blocking and other Loch Ness Monsters at #HIMSS16

Posted on March 2, 2016 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

A torrent of tweets was unleashed on Day 2 of #HIMSS16. According to Symplur, almost 30,000 tweets were sent with the #HIMSS16 hashtag yesterday.

One tweet was particularly memorable:

The quote comes from John Halamka, CIO of Beth Israel Deaconess Medical Center, who was discussing the controversial act of information blocking – where vendors proactively block the sharing of information health information. John Lynn posted a fantastic summary of information blocking here.

That tweet stuck with me and for the rest of Day 2 at #HIMSS16 I was on the lookout for Loch Ness Monsters – things that get discussed, but are almost never seen.

Loch Ness Monster #2 – Interoperability

A close cousin to information blocking – interoperability has been a popular topic again this year at HIMSS. Many vendors are touting new APIs and tools that help make data exchange easier. The HHS even unveiled plans for several initiatives to pave the way for easier information sharing. However, like in previous years, there is a lot of talk, but very little action when it comes to interoperability.

There is frankly very little financial incentive for vendors and institutions to be open with their data. So until the economics change, interoperability will remain a Loch Ness Monster.

Loch Ness Monster #3 – Gender parity

The #HealthITChicks tweetup led by Jennifer Dennard of HISTalk highlighted the issue of gender inequality in healthcare IT. Dennard and a panel of three respected women leaders discussed the progress-made and the progress-yet-to-be made in terms of women being fully accepted as equals in the industry.

The panel pointed to the results of the annual HIMSS Leadership Survey which were revealed in a morning briefing. A key finding of the survey was gender-based pay inequality – “Evidence from the Compensation Survey, for example, suggest female health IT workers are being marginalized in this sector of the economy. Analyzed several different ways, women consistently earn less than their male counterparts. The findings also suggest females are under-represented in IT-related executive and senior management roles in the health sector.”

So apparently we talk a lot about women being equal, but the it’s simply not something that’s seen.

Loch Ness Monster #4 – Patients

HIMSS is by far the largest healthcare IT conference in North America. It attracts attendees from across the spectrum of healthcare. However, there is one stakeholder that is nearly absent – patients. Every vendor talks about including patients in the design of their products and how they consider themselves to be “patient centered” yet there are only a handful of patient advocates and e-Patients at the conference.

Progress has been made in the past few years in terms of patient scholarships, but more can be done to ensure that the voice of the patient is actually seen/heard at the annual HIMSS conference. It’s time for vendors and health institutions to step up.

Loch Ness Monster #5 – Stable WiFi

In the lunch lines, restroom lines and in the aisles of the Exhibit Hall, #HIMSS16 attendees were all asking each other if they knew of a good place to get a stable WiFi signal. To be fair, WiFi coverage this year has been much better than in years past, but there still plenty of people talking about “If you go over there by the window and just under the escalator you’ll get a strong signal”. On two occasions I want to the exact spot recommended by a fellow attendee – only to be disappointed with a single bar of signal strength. My hotspot has rarely seen this much activity in a single day.

What things have you HEARD at #HIMSS16 but have not actually SEEN?