The meaningful use EHR incentive program served its purpose of getting hospitals to implement electronic health records platforms. Now, renamed as promoting interoperability, the next phase is to advance the federal government’s approach to enabling those organizations to actually share health data more effectively.
“The job of meaningful use is done, now it’s a rebranding of the program to focus on the interoperability piece,” said Jeff Coughlin, senior director, Federal and State Affairs for HIMSS. “This was definitely in line with a lot of what stakeholder groups were talking about: meaningful use would become more inline with the quality payment program.”
To that end, CMS unveiled the hospital inpatient payment program proposed rule and other initiatives that put interoperability front and center across the Department of Health and Human Services. The agency is also looking to break down barriers preventing the sharing of information among providers, and between clinicians and patients.
“We have to give CMS an ‘A’ for effort in their attempt to simplify the terms and conditions for hospitals,” said David Kibbe, MD, CEO of DirectTrust.
Conditions of participation
To advance the new promoting interoperability program, CMS posted a request for information to get feedback on conditions of participation. In the RFI, CMS is requesting stakeholder feedback about the possibility of revising conditions of participation with the end goal of increasing health information exchange.
CMS doesn’t often open up the conditions of participation, and coming as it does around interoperability initiatives, this is “significant,” Coughlin said. “The idea of change is a big step. I think it’s one of the policy levers CMS could pull here.”
Indeed, Kibbe said that some people in the industry wanted ONC to change EHR certification criteria.
“Given that quite a few vendors have already gone down the road of certification under the 2015 Edition criteria, the decision to apply them in 2019 makes a lot of sense,” Kibbe said.
Among the hurdles to widespread interoperability is the practice of information blocking, an issue Congress mandated that the Office of the National Coordinator for Health Information Technology address under the 21st Century Cures Act.
“Everything that CMS is proposing is coordinated with what ONC is doing,” Coughlin said. “The ONC has a difficult task in defining what information blocking is not.”
Promoting Interoperability, for instance, includes the use of application programming interfaces, or APIs for patients to collect their health information from multiple providers, and to potentially incorporate all of their data into a single portal, or application.
“As part of ONC’s role in coordinating health information technology nationally, we are working with innovators to develop modern APIs that support the use of mobile apps to help individuals manage their own health or the health and care of a loved one,” National Coordinator Donald Rucker, MD, wrote on ONC’s Health IT Buzz blog. “A robust health app ecosystem can lead to disease-specific apps and allow patients to share their health information with researchers working on clinical trials to test a drug or a treatment’s efficacy, or monitoring outcomes like those in the National Institutes of Health’s All of Us Research Program.”
Kibbe added that “giving patients choices as to what technologies they use to manage their health information is quite important, as a one-size app or transport via FHIR and APIs doesn’t necessarily fit all needs.”
And there’s one more aspect of the changes that will be widely appreciated throughout the healthcare industry.
“A lot of people will be happy they don’t have to say ‘meaningful use’ anymore,” Coughlin said.