CHIME Responds to Modified Meaningful Use Rules

Following the release today of the finalized modified rules for the current stage of meaningful use, CHIME released the following statement, summarizing the position of many in healthcare. Overall, the organization supports the modifications, including the adopted 90-day reporting period:

We are pleased that the Centers for Medicare & Medicaid Services today finalized modifications to the current stages of the Meaningful Use program and agreed to extend the comment period on Stage 3. CHIME and its 1,700-plus members agree with CMS that it is time to focus the meaningful use program on adoption of information technology systems that improve both the quality and safety of patient care.

The 752-page rule grants flexibility for providers who are doing their best to not only meet the intent of the federal program, but also ensure the adoption of health information technology that improves patient care.

Importantly, the rule adopts a 90-day reporting period for the current stages of the program, down from 365 days. CHIME has long called for a 90-day reporting period and applauds CMS for adopting this new standard. While several members are positioned to take advantage of this shorter period, others will be challenged to meet it since there are fewer than 90 days remaining in the year. We urge CMS to implement a hardship exemption for those unable to meet this timeframe.

CHIME also applauds the agency for modifying requirements surrounding patient access to electronic records. The rule stipulates that for 2015 and 2016, one patient discharged from a hospital view, download or transmit their electronic record.

With regard to Stage 3, the extra comment period will enable providers, CMS and other stakeholders to ensure that the next stage of Meaningful Use advances interoperability and takes into account new payment models being advanced by Medicare.

Also today, the Office of the National Coordinator for Health Information Technology finalized a rule on certification of electronic health records. CHIME supports key provisions in the rule that should lead to greater transparency regarding vendor products; improved testing and surveillance of health IT, and an improved focus on user-centered design.

We are reviewing the regulations and will have more detailed comments in the coming days.

Most Wired Hospitals Focused on Health Data Security and Patient Engagement

Health data security and patient engagement are top priorities for the nation’s hospitals, according to results of the 17th annual HealthCare’s Most Wired Survey, released today by the American Hospital Association’s Health Forum and the College of Healthcare Information Management Executives (CHIME).

The 2015 Most Wired survey and benchmarking study, in partnership with CHIME and sponsored by VMware, is a leading industry barometer measuring information technology (IT) use and adoption among hospitals nationwide. The survey of more than 741 participants, representing more than 2,213 hospitals, examined how organizations are leveraging IT to improve performance for value-based healthcare in the areas of infrastructure, business and administrative management, quality and safety, and clinical integration.

According to the survey, hospitals are taking more aggressive privacy and security measures to protect and safeguard patient data. Top growth areas in security among this year’s Most Wired organizations include privacy audit systems, provisioning systems, data loss prevention, single sign-on and identity management. The survey also found:

“With the rising number of patient data breaches and cybersecurity attacks threatening the healthcare industry, protecting patient health information is a top priority for hospital customers,” said Frank Nydam, senior director of healthcare at VMware. “Coupled with the incredible technology innovation taking place today, healthcare organizations need to have security as a foundational component of their mobility, cloud and networking strategy and incorporated into the very fabric of the organization.”

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CHIME Co-Founder Richard Correll to Retire

Richard Correll
Richard Correll

Co-founder and former president and CEO of the College of Healthcare Information Management Executives (CHIME) Richard A. Correll announced his plans to retire at the end of the month, after 23 years. Correll has been serving as the organization’s chief operating officer and senior strategic advisor since April 2013 following the appointment of CEO Russell P. Branzell.

Correll has led the CHIME organization since it was created more than two decades ago as a nonprofit, professional association for senior IT leaders in healthcare.

“My years serving CHIME have been a privilege and the most rewarding of my career,” said Correll in a statement. “With the indispensable support of our members, board and staff, the organization has become a recognized leader and advocate for the CIO role and the effective use of information management to improve patient care quality and safety.

Correll helped forme CHIME in 1992, enlisting 192 charter members in the first year, led by founding board chair Dr. John Glaser. While serving on the HIMSS board in the 1980s, Correll identified the need for a professional organization dedicated to the development of the emerging top healthcare IT executives taking on the new title of CIO. Today, CHIME has grown to more than 1,500 members and 150 Foundation firm supporters.

“Our ability to utilize information technology to improve the quality, safety and efficiency of care has been significantly furthered because of the efforts of Rich Correll,” said Glaser, senior vice president of Cerner in a statement. “Rich’s creation and leadership of CHIME have led to major advances in the knowledge, skills and capabilities of the healthcare IT leadership community. His legacy is substantial; we all have been shaped his work.”

After CHIME was formed, Correll and Glaser spearheaded the creation of the CHIME Foundation in 1994, comprised of healthcare IT vendors and consultants to partner with the members of CHIME, and in 2007, a second office location in Washington, D.C. to create sustained contact with lawmakers while informing and influencing federal policies meant to transform the delivery of healthcare through IT.

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Meaningful Use Stage 3: Sink or Sail

As the comment period has come and gone (ended May 29, 2015) for meaningful use Stage 3, and as multiple organizations, like CHIME, and countless other individuals have taken the time to comment on the final rule, I thought it was a good time to ask the question: Does the meaningful use Stage 3 rule sail or sink?

Procuring responses to this question from a number of health IT insiders helps to identify some of the most pressing issues with the final stage of meaningful use, a topic that is almost second to none in regard to generating support or opposition from those in the sector.

The College of Healthcare Information Management Executives, in its comments on the rule, called federal plans for the third stage of meaningful use too ambitious and in need of several important changes, but still offered their support for a corresponding CMS proposal that would shorten meaningful use reporting in 2015 from a full year to any continuous 90-day period. In total, CHIME said meaningful use Stage 3 is “unworkable.”

“Were all requirements finalized as proposed, we doubt many providers could participate in 2018 successfully,” CHIME said. “And with so few providers having demonstrated Stage 2 capabilities, we question the underlying feasibility of many requirements and question the logic of building on deficient measures.”

Bennett Lauber
Bennett Lauber

Bennett Lauber, chief experience officer, at The Usability People offered a slightly different take: “The MU3 program contains some well-needed enhancements to the Safety-enhanced design portion of the 2015 certification criteria. They have also proposed significant changes to the Safety-enhanced Design (aka usability) testing requirements. These new requirements might seem burdensome to some of the smaller EHR vendors, as they require 17 and not seven items to be usability tested and finally set a minimum number of participants for these studies and more. With everyone complaining about the (lack of) usability of healthcare software these additional requirements should be welcome as they force the vendors to perform real summative usability tests and as a result it eventually might actually save lives.

David Muntz
David Muntz

David Muntz, former principal deputy director of the ONC and current CIO of GetWellNetwork adds, “Getting to a common stage is a good thing, but there is still some concern expressed by those who are struggling with the move from Stage 1 and Stage 2 to the future state. The limit on adding new elements is a positive, though some of the thresholds that need to be met will be a concern to many, particularly those that require a provider to affect behaviors in the patients. Standardizing quality measures and adjusting the reporting period are good moves, but the possibility of requiring all vendors to have a complete set will delay release dates.

“The encouragement to add APIs for data exchange is a positive. More thought, however, is needed to the areas where open APIs can prove beneficial. Secure messaging is great, but the threshold for usage is really based on patient preference and may be a bit aggressive. The greatest disappointment was the continued use of specific features and functions without an alternative to deem features and functions based on a combination of appropriate process and outcome measures. A deeming approach would have given the users a great deal of latitude in how to implement features and functions that would have produced favorable outcome.”

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CHIME Issues National Patient ID Challenge

Russell P. Branzell
Russell P. Branzell

The College of Healthcare Information Management Executives (CHIME), the professional organization for chief information officers and senior IT executives, is calling on innovators throughout the U.S. to participate in the CHIME National Patient ID Challenge.

In an effort to find a universal solution for accurately matching patients with their healthcare information, CHIME will launch a $1 million challenge early this summer on the HeroX platform, co-founded by XPRIZE CEO Dr. Peter Diamandis.

The digitization of the U.S. healthcare system maintains that electronic health records must be able to seamlessly share and exchange information. According to CHIME, interoperability is not enough — to realize their full potential, patient data contained in the EHR must be accurate to support the requirements of coordinated, accountable, patient-centered care, the organization says.

“There is a growing consensus among payers and providers that a unique patient ID would radically reduce medical errors and save lives,” said CHIME CEO and president Russell P. Branzell, FCHIME, CHCIO.”Incomplete or duplicate health records present significant issues in terms of patient safety, and there is a pressing need for preventing, detecting and removing inaccurate records so hospitals can positively match the right data with the right patient in order to provide the best possible care.”

Duplicate or inaccurate patient records can occur from manual data entry errors, or when two or more individuals share the same name. This presents considerable concern for different individuals being identified as the same patient, potentially resulting in inadequate treatment or unintended injury.

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CHIME: Low Stage 2 Attestation Numbers Validate Need for Shortened Reporting Period in 2015

The College of Healthcare Information Management Executives (CHIME) is reiterating its call to immediately shorten the reporting period for 2015, as substandard meaningful use low Stage 2 attestation numbers lag for the 2014 program year, the organization said in a statement.

According to the data recently released by the Centers for Medicaid and Medicare Services (CMS) during the Health IT Policy Committee meeting, less than 35 percent of the nation’s hospitals have met Stage 2 meaningful use requirements. While eligible professionals (EPs) have until the end of February to report their progress, just 4 percent have met Stage 2 requirements thus far, CHIME cited.

“Despite policy efforts to mitigate a disastrous program year, today’s release of participation data confirms widespread challenges with Stage 2 meaningful use,” said CHIME president and CEO Russell P. Branzell, FCHIME, CHCIO.

Roughly one in three hospitals scheduled to meet Stage 2 in 2014 had to use alternative pathways to meet MU, administrative data current through December 1 indicates.

“This trend demonstrates how vital new flexibilities were in 2014 and again, underscores the need for the same flexibility in 2015,” said Branzell. “It is imperative officials take immediate action to put this critical transformation program back on track. Shortening the time frame for MU reporting in 2015 will help to ensure the program delivers on its promise to advance the transformation of healthcare in this country.”

CHIME and several other national provider associations have repeatedly told CMS that without more program flexibility and a shortened reporting period in 2015, the future of Meaningful Use is in jeopardy.

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CHIME and HIMSS Force ONC to Face a Poor Perception of Itself

CHIME and HIMSS are in the news again, and this time you’ve got to love that they are — for sticking up for what they, as organizations, believe in. Their flexing of a little muscle is for telling ONC that its leadership and its current efforts just are not good enough; referring to the announcement that Dr. Karen DeSalvo, current national coordinator for health information technology, is splitting here duties between ONC and HHA, where she’s battling Ebola.

CHIME, especially, is known for its bravado, one of the reasons I find it such an intriguing organization to watch. Its messages are always loud and clear, and unadulterated; just what we need in an overly PC public where “the folks” are supposed to take what’s given to them.

CHIME and HIMSS’ letter is more about the overall leadership changes taking place at ONC and the organizations’ apparent difficulty keeping leadership in place; DeSalvo has led the organization for less than a year. “We are concerned with leadership transitions currently occurring within the Office of the National Coordinator for Health Information Technology (ONC); changes which could have a detrimental effect on ONC’s role in HHS’ charge to positively transform our nation’s health system,” CHIME and HIMSS’ letter to ONC states.

“Health IT is a dynamic field; to successfully address the needs of patients, providers and developers, ONC’s leadership team must be in place over the next two years. Such constancy will pay huge dividends in navigating all the changes that must occur for positive transformation.”

CHIME and HIMSS point out the obvious in their missive: That ONC faces a public that perceives its leadership as not wanting to be at the organization, much in the same vein as what’s going on at the White House amid reports that a disengaged Obama is counting down his last days as President.

As ONC’s leadership publically takes a willy-nilly approach, CHIME, HIMSS and others are done looking on wondering what’s up and are starting to demand some action. A half-hearted approach to leadership is not going to work, not now, not after so many of its programs that ONC lobbied for and put in place while practices and health systems looked on wondering how to deal with the swarm of new mandates and regulations.

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Release of Meaningful Use Data Prompts Industry Leaders to Urge HHS to Shorten Reporting Period

Healthcare leaders from across the nation are renewing calls for the Centers for Medicaid and Medicare Services (CMS) to shorten the meaningful use (MU) reporting period in 2015 and provide more program flexibility, citing concerns with lower-than-expected Medicare numbers and continued reports detailing nationwide difficulty in meeting federal guidelines for electronic health records (EHR) requirements.

According to newly released CMS numbers, less than 17 percent of the nation’s hospitals have demonstrated Stage 2 capabilities. Further, less than 38 percent of eligible hospitals (EHs) and critical access hospitals (CAHs) have met either stage of meaningful use in 2014, highlighting the difficulty of program requirements and foretelling continued struggles in 2015. And while eligible professionals (EPs) have until the end of February to report their progress, only 2 percent have demonstrated Stage 2 capabilities thus far.

Officials from the American Medical Association (AMA), College of Healthcare Information Management Executives (CHIME), Healthcare Information and Management Systems Society (HIMSS) and Medical Group Management Association (MGMA) called the results disappointing, yet predictable.

“Meaningful use participation data released today have validated the concerns of providers and IT leaders. These numbers continue to underscore the need for a sensible glide-path in 2015,” said CHIME president and CEO Russell P. Branzell, FCHIME, CHCIO. “Providers have struggled mightily in 2014, in many instances for reasons beyond their control. If nothing is done to help them get back on track in 2015, we will continue to see growing dissatisfaction with EHRs and disenchantment with meaningful use.”

CMS data required by Congress indicate that more than 3,900 hospitals must meet Stage 2 measures and objectives in 2015 and more than 260,000 eligible professionals (EPs) will need to be similarly positioned by January 1, 2015. Given the low attestation data for 2014 and the tremendous number of providers required, but likely unable to fulfill, Stage 2 for a full 365-days in 2015, healthcare leaders have pressed for a shortened reporting period in 2015, mirroring the policy of 2014.

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Electronic Health Records Usability: CIOs Weigh In

Electronic health records uptake in the U.S. has accelerated dramatically as a result of government initiatives and the considerable resources – both capital and time – healthcare providers have invested over the past five years. Electronic health records have become the heart of health IT, and U.S. clinicians use them on a daily basis.

Frost & Sullivan’s newest health IT analysis, “EHR Usability—CIOs Weigh in On What’s Needed to Improve Information Retrieval,” finds that as the market matures and the volume of EHR data proliferates, ensuring reliable information retrieval from EHRs at the point-of-care will become  a priority for healthcare providers.

In spite of significant progress in EHR adoption, the road is paved with pitfalls for many providers. Frequently highlighted customer pain points include:

“U.S. regulatory authorities will take notice of the growing chorus of complaints about EHR usability, resulting in a push to devote more resources to solving this issue,” said Frost & Sullivan Connected Health Principal Analyst Nancy Fabozzi. “Further, the high levels of end-user frustration with usability present strong business opportunities for pioneering technology vendors.”

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CHIME: Healthcare IT Leaders Embrace Federal Interoperability Plans

The College of Healthcare Information Management Executives released the following statement in support of embracing federal interoperability plans:

The federal government’s top health IT advisers recently made recommendations on how public and private stakeholders should progress toward interoperability in healthcare. Leaders from the College of Healthcare Information Management Executives (CHIME) and Health Level Seven International (HL7) embraced the recommendations of the JASON Task Force, calling them a significant step forward in achieving the promise of information technology in healthcare. CHIME and HL7 also highlighted the need to incorporate critical enhancements to standards currently under development for meaningful use Stage 3.

During a joint meeting of the Health IT Standards and Health IT Policy Committees, federal officials discussed new details regarding a national interoperability roadmap and outlined concrete recommendations meant to improve the appropriate access and use of health data. The JASON Task Force said that a solid foundation for interoperability should utilize public APIs, advance modern communications standards, such as HL7’s Fast Healthcare Interoperability Resources (FHIR), and use meaningful use Stage 3 as a pivot point to initiate this transition.

FHIR is a simple-to-use format that can improve interoperability for a range of technologies, including EHRs, patient-centric solutions and mobile applications. A next generation standards framework created by HL7, FHIR combines the best features of HL7’s Version 2, Version 3 and CDA product lines while leveraging the latest web standards and applying a tight focus on implementability.

“Today’s discussion and the recommendations of the JASON Task Force represent an evolution in thinking,” said CHIME president and CEO Russell P. Branzell, FCHIME, CHCIO. “The updated roadmap and the recommendations put forth by the JASON Task Force incorporate a tremendous amount of stakeholder input and articulate the challenges facing our industry much more completely than previous efforts.”

“The prioritization of standards-based interoperability and a commitment to long-term policymaking will enable healthcare to benefit from information technology in very tangible ways,” said Charles Jaffe, MD, PhD CEO of HL7.

CHIME and HL7 believe important recommendations were accepted by the full Health IT Standards and Health IT Policy Committees. HL7 and CHIME also support allowing time to make meaningful use Stage 3 more impactful with the inclusion of key standards that are still under development. “There remains a disconnect between artificial government timelines and the realities of standards and technology development,” Branzell said. “This highlights a principle concern with how health IT policy is created, adopted and implemented at the federal level.”

CHIME and HL7 are committed to collaboration in the advancement of health IT initiatives such as FHIR and support government efforts on the interoperability roadmap.

CHIME is an executive organization dedicated to serving chief information officers and other senior healthcare IT leaders. With more than 1,400 CIO members and more than 140 healthcare IT vendors and professional services firms, CHIME provides an interactive environment enabling senior professional and industry leaders to collaborate; exchange best practices; address professional development needs; and advocate the effective use of information management to improve the health and healthcare in the communities they serve.