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ONC official: Hospitals may already be familiar with new MACRA provisions

BALTIMORE –Two main points stood out most when a leading ONC official took the stage at today’s AHIMA conference: MACRA and data segmentation for patient privacy.

The release of the final MACRA rule last week wasn’t the focus of the keynote from Andrew Gettinger, M.D., CMIO of the U.S. Office of the National Coordinator for Health IT (ONC). Instead, he sought to reassure healthcare organizations about preparing for MACRA, more formally called the Medicare Access and CHIP Reauthorization Act.

MACRA has familiarity

Gettinger explained that ONC came out with its third round of certification regulations in the fall of 2015, and those regulations “are the requirements that are baked into MACRA.” Thus, organizations already are familiar with those requirements, which will help with compliance, he said.

Given that the certification regulations released last fall are a part of MACRA and that the rule won’t go into effect until 2018, Gettinger said that there should be enough time and resources for providers to prepare. He added that ONC released the Enhanced Oversight and Accountability Proposed Rule that states the agency will help out struggling healthcare organizations.

However, “we’re still working out exactly how that’s going to work,” he said.

Data segmentation for privacy

Many in healthcare advocate for patients to have control over their health information. And while Gettinger supports this movement, he also waves a flag of caution.

“I am fully supportive of patients having control of their data. Fully supportive,” Gettinger said. “I am not supportive of circumstances where key and critical information can be concealed.” This could potentially cause problems when it comes to caring for the patient.

Gettinger gave an example in which data was segmented and left out for the purpose of patient privacy, which may have complicated the care administered to the patient and resulted in a death. An adolescent was admitted to the ER in the middle of the night. She had meningitis, a fever and sweats.  Clinicians gave her Demerol, a common treatment, but she died. It turned out that her family had withheld information concerning the young woman’s depression and that she was taking an antidepressant.

The fact that the family had full control of the patient’s information may have hampered the clinicians’ ability to treat her. “The [Demerol] treatment choice was reasonable for the data [the doctors] had,” Gettinger said.