Outgoing national health IT coordinator Farzad Mostashari, M.D., will continue pushing health data interoperability and, more importantly, accelerating health information exchange (HIE) adoption in U.S. healthcare up until his last day on the job, widely assumed to be in September.
We intend to develop and implement a set of policies and programs that encourage providers to routinely exchange health information in support of care coordination across healthcare settings.
Farzad Mostashari, M.D.,
national coordinator of health IT
In a webcast that responded to a request for information (RFI) issued earlier this year that solicited suggestions to accelerate HIE adoption, representatives from CMS and Office of the National Coordinator for Health IT (ONC) outlined their strategy for making HIE between providers happen more quickly. ONC also issued a white paper expanding on the announcement.
The policy paper reflects the latest strategy of the Department of Health and Human Services of using the financial levers at its disposal to encourage HIE while keeping governance in the hands of the private sector. Last year, ONC tabled a potential plan to govern national HIE through formal regulatory rule making.
Mostashari said that questions and comments received from more than 200 respondents through the RFI showed that there still is uncertainty about ONC's roadmap for HIE in U.S. healthcare, despite the agency's efforts to publicize it through advisory committee meetings and on the Standards & Interoperability Framework wiki. They will work to make their plans clearer, he said.
Furthermore, he said ONC will work to encourage development of open source alerts that notify primary care providers that their patients have had activity at a hospital when an admission, discharge or transfer occurs.
Mostashari continued by saying that ONC also plans to develop a software certification program for applications used by behavioral health and long-term post-acute care providers. Representatives from those healthcare sectors asked ONC to offer similar certifications for health data interoperability and exchange features that currently exist for acute care and outpatient EHRs.
"We're going to move ahead to see what the scope and criteria should be, starting kind of small, for a voluntary -- and I emphasize the 'voluntary' -- certification program," Mostashari said. "We'll move forward on scoping that out."
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For their part, CMS authorities on the webcast said they plan to tie HIE use and acceleration to reimbursement policies for Medicaid, Children's Health Insurance Program and the Basic Health Program. Another example of CMS' tying HIE to reimbursement: Its latest physician fee schedule proposed a new complex chronic care management fee predicated on the e-summary of care record exchange and meaningful use.
Rob Tagalicod, director of the Office of E-Health Standards and Services, stressed that CMS is sensitive to fears about new unfunded mandates among healthcare providers. Therefore, in its promotion of faster HIE adoption, the agency will strive to build incentives into its reimbursement schedules when possible instead of cutting reimbursements.
"We wish to communicate as clearly as possible," Mostashari said to the 1,000 listeners online, "that we intend to develop and implement a set of policies and programs that encourage providers to routinely exchange health information through interoperable systems, in support of care coordination across healthcare settings."