Health
information management leaders told members of Congress today that removal of a
nearly two-decade ban on the use of federal funds to adopt a nationwide unique
patient identifier would allow collaboration between the U.S. Department of
Health and Human Services (HHS) and the private sector to identify solutions
for reducing medical errors and protecting patient privacy.
During the
briefing, members of the American Medical Informatics Association and the
American College of Surgeons joined AHIMA and CHIME in recounting existing
patient identification challenges and the patient safety implications when data
is matched to the wrong patient and/or when essential data is lacking from a
patient’s record due to identity issues.
“Critical to
patient safety and care coordination is ensuring patients are accurately
identified and matched to their data,” said AHIMA CEO Wylecia Wiggs Harris,
PhD, CAE. “The time has come to remove this archaic ban and empower HHS to
explore a full range of patient matching solutions hand in hand with the
private sector focused on increasing patient safety and moving us closer to
achieving nationwide interoperability.”
“Now more than
ever we need a nationwide unique patient identifier to ensure that patients are
correctly identified in our increasingly digital healthcare ecosystem,” said
CHIME President and CEO Russell Branzell. “This is a top priority for our
members. We applaud the House for taking a leadership role on this issue by
removing the ban and we strongly encourage the Senate to do the same.”
The Health Insurance Portability and
Accountability Act (HIPAA) originally required the creation of a unique health
identifier in 1998. However, Congress included language as part of the annual
appropriations process that prohibited the US Department of Health and Human
Services from using federal funds intended for the creation of a unique patient
identifier out of privacy concerns.
Not having a unique patient
identifier system means that healthcare providers typically rely on a patient’s
name and date of birth to identify their medical records in electronic health
record (EHR) systems—information that is often not unique to one individual.
This means that providers often have a difficult time properly identifying
patients and often incorporate medical information into the wrong health
record.
“Those of us
who work in provider organizations have seen the serious consequences of this
ban on patients and their families,” said Marc Probst, CIO at Intermountain
Healthcare and a member of the CHIME Policy Steering Committee.
“Misidentifications threaten patient safety and drive unnecessary costs to
health systems in an era when the industry and Congress are trying to lower
healthcare costs. Congress has an opportunity to fix this, but only if the
Senate also removes the ban on a unique patient identifier.”
Speakers at the
briefing included:
Marc Probst, MBA, CHCIO, chief information officer and vice president, Intermountain Healthcare
Shaun Grannis, MD, MS, FAAFP, director, Center for Biomedical Informatics, Regenstrief Institute, Inc.
Frank G. Opelka, MD, FACS, medical director, Quality and Health Policy, American College of Surgeons
Katherine Lusk, MHSM, RHIA, FAHIMA, chief health information management and exchange officer, Children’s Health System of Texas
Moderators, Leslie Krigstein, vice president congressional affairs, CHIME and Lauren Riplinger, vice president policy and government affairs, AHIMA
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.
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:
96 percent of Most Wired organizations use intrusion detection systems compared to 85 percent of the all respondents. Privacy audit systems (94 percent) and security incident event management (93 percent) are also widely used.
79 percent of Most Wired organizations conduct incident response exercises or tabletop tests annually, a high-level estimate of the current potential for success of a cybersecurity incident response plan, compared to 37 percent of all responding hospitals.
83 percent of Most Wired organizations report that hospital board oversight of risk management and reduction includes cybersecurity risk.
“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.”
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.
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, 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, 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.”
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.
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.
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.
