HIT Policy Committee Returns After Government Shutdown

The Health IT Policy Committee held its first meeting since September, having cancelled the October meeting due to the government shutdown. The virtual meeting featured several speakers from the Centers for Medicare and Medicaid Services (CMS), the Office of the National Coordinator for Health IT (ONC), the Privacy and Security Tiger Team, the Information Exchange Workgroup and the Quality Measure Workgroup.

The most notable presentations were given by ONC and the Quality Measure Workgroup. Jennifer King from ONC presented the latest numbers on 2014 product certification for eligible hospitals and providers who have already purchased a 2011 certified product. A number of infographics were employed to illustrate the state of program, but highlights include the following:

  • 81% of eligible hospitals (EHs) that attested to Stage 1 used one of 9 vendors that now have a 2014 certified Base EHR product
    • Another 3% of EHs (total of 84%) used a vendor that now has a 2014 certified (not a Base EHR)
  • 58% of eligible professionals (EPs) that attested to Stage 1 used one of 21 vendors that now have a 2014 certified Base EHR product
    • Another 11% of EPs (total of 69%) used a vendor that now has a 2014 certified product (not a Base EHR)
  • There is no identifiable gap between rural and urban providers
  • There is no identifiable gap between specialties with the exception of the radiology/pathology/anesthesiology group

The Quality Measure Workgroup provided the first in-depth look at deeming for Stage 3 objectives and measures. The workgroup developed a draft framework and proposed the following draft criteria against which measures appropriate and eligible for deeming would be evaluated. They are:

  1. Preference for eCQMs or measures that leverage data from HIT systems (e.g., clinical decision support)
  2. Enables patient-focused view of longitudinal care
  3. Supports health risk status assessment and outcomes
  4. Preference for reporting once across programs that aggregate data reporting
  5. Applicable to populations
  6. Benefit Outweighs Burden
  7. Promotes shared responsibility

To demonstrate how these criteria might be used, the workgroup developed some examples (available here: slides 11-13). The workgroup and the committee at large recognized how complex the concept of deeming is. The committee applauded the Quality Measures Workgroup for its initial work and affirmed the direction for future work. The workgroup has recommended the following for further development:

  • EH/EP measuring together for mutual benefit
  • Group reporting option
  • Population health aligned with new business models
  • Interoperability that matters
  • Measures that depend on data from outside the current provider/organization
  • Measurement coordination with non-eligible providers (e.g. behavioral health, long term care)
  • Infrastructure and architecture for ACO measurement

During the meeting, CMS also provided an update on the EHR Incentive Program, reporting the following numbers:

  • 424,000 active registrations as of end of September
    • Hospitals: 91% registered; 82% paid
    • EPs: 80% registered; 60% paid
  • $16.5 billion paid out (program to date)
  • Approximately 83% of all eligible hospitals have received an EHR incentive payment for either MU or AIU
    • More than 8 out of 10 eligible hospitals have made a financial commitment to an EHR
  • Approximately 56% or more than 1 out of every 2 Medicare EPs are meaningful users of EHRs
  • Approximately 73% or nearly 3 out of every 4 Medicaid EPs of have received an EHR incentive payment
    • 16% of Medicaid EPs are meaningful users

Presentation materials for all updates can be found here.

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