CMS 'Aggressively' Seeks Sharing of Electronic Health Records Across Providers

The Centers for Medicare and Medicaid Services (CMS) has announced plans for the next step in the evolution of electronic health records (EHRs): sharing them between healthcare providers.

The vision for EHRs has long been that a patient’s medical information would reside on a platform that would enable easy yet secure access by all providers, rather than have each provider electronically store its respective piece of a patient’s medical history.

Earlier this week CMS Acting Administrator Marilyn Tavenner and the National Coordinator for Health Information Technology Farzad Mostashari, M.D. announced the U.S. Department of Health and Human Service’s plan “to accelerate health information exchange (HIE) and build a seamless and secure flow of information essential to transforming the health care system,” according to an HHS press release.

“Health IT and the secure exchange of information across providers are crucial to reforming the system, and must be a routine part of care delivery,” said Tavenner.

HHS has issued a request for information to vendors and providers “seeking public input about a variety of policies that will strengthen the business case for electronic exchange across providers to ensure patients’ health information will follow them seamlessly and securely wherever they access care.” Those goals and policies include:

• Increasing use of EHR. HHS wants 50 percent physician offices using electronic health records (EHR) and 80 percent of eligible hospitals receiving meaningful use incentive payments by the end of 2013.
• Enhancing the effective use of electronic health records through initiatives such as the Blue Button initiative. Medicare beneficiaries can access their full Medicare records online today. HHS is working with the Veterans Administration and more than 450 different organizations to make health care information available to patients and health plan members. HHS is also encouraging Medicare Advantage plans to expand the use of Blue Button to provide beneficiaries with one-click secure access to their health information.
• Implementing Meaningful Use Stage 2. HHS is implementing rules that define what data must be able to be exchanged between Health IT systems, including how data will be structured and coded so that providers will have one uniform way to format and securely send data.
• Underscoring program integrity. HHS is taking new steps to ensure the integrity of the program is sound and technology is not being used to game the system. For example, it is conducting extensive medical reviews and issuing Comparative Billing reports that identify providers.

HHS recognizes that these goals are ambitious and not easily achieved. “Economic and regulatory barriers may impair the development of a patient centered, information rich, high performance health care system where a persons’ health information follows them wherever they access health care services,” the federal department writes in its RFI. “With fee-for-service reimbursement and other business motivations often being the stronger influencer of provider behavior, both providers and their vendors do not yet have a business imperative to share person level health information across providers and settings of care.”

The deadline for comments is April 21, 2013.