We talk about “silos” of information in the health IT industry and we must really wonder whether such one-way communication models also exist at the federal level.
Last month the Centers for Medicare & Medicaid Services (CMS) released its proposed rule for the establishment of accountable care organizations (ACOs). While the rule is part of a larger payment reform objective created by the health reform law, it is not without a slew of technology requirements, including the use of electronic health record (EHR) systems and other types of IT for care coordination.
Some of the proposed requirements in that rule would have providers using EHRs by 2013 in ways that aren’t even mandated by the 2015 deadline through another major ruling currently being implemented — the meaningful use program.
Since the same federal agency is responsible for both rules, perhaps its offices need some of that interoperability being required of the health care industry.
In a recent meeting of the Health IT Policy Committee, or HITPC, which is charged with providing recommendations on the meaningful use requirements, policymakers and industry representatives debated the timeline for Stage 2 of the program. Some within the committee are suggesting lengthening the time in which providers must get up to speed, while others are concerned about losing momentum if the industry is given more time.
Considering, however, that Stage 1 of meaningful use just got underway this year, waiting to see how well providers fare now before handing them Stage 2 might make sense. Not to mention that the industry is facing the implementation of myriad rulings in the next few years — all with extensive IT investments and time commitments in an environment where patient care must continue at a level of high quality.
At the HITPC meeting, businessman and software entrepreneur Paul Egerman, a member of the committee, put it into perspective: “My opinion is the ACO thing is going to eat the meaningful use thing for lunch.”
And if it doesn’t, perhaps it will devour the version 5010 update and ICD-10 transition or the upgrade to HIPAA privacy and security enforcements — mandates that providers have to implement in the next two years. Indeed, the care coordination technology required in the proposed ACO rule simply does not exist in current versions of the systems and applications on which CMS is staking its goals. Much of those objectives are the reason that the meaningful use program was created through the HITECH Act in the first place.
The question is: What are the goals of the industry? Tony Trenkle, acting director of CMS’ Office of Information Services, said during the HITPC meeting that factoring in the various rules and how they influence the meaningful use program, as well as aligning objectives would help alleviate the burden on providers. “That has to be considered as a driver.”
Perhaps the agencies will consider those drivers, or simply talk to one another, before writing more rules.