With the release of two different final rules, the federal government is trying to make it easier for doctors to use electronic health records and to report data on practice outcomes, leaders at two Health and Human Services agencies said Friday.
The Office of the National Coordinator for Health Information Technology held two conference calls with reporters to outline final rules issued for two sets of regulations: the Health IT Certification Program and the health information technology portion of the Medicare Access and CHIP Reauthorization Act.
The Health IT Certification Program rule addresses three areas, officials said: it allows the agency to directly review certified health IT products and take action including decertification if health and safety issues or other problems arise; it establishes a way for the ONC to oversee accredited testing tabs for health IT programs; and it allows for health IT surveillance results to be made public.
“With the vast majority of physicians and hospitals now using health IT, the ONC plays an important role in helping make sure these products operate appropriately in the field,” Vindell Washington, MD, who heads ONC, said on the morning conference call.
“Because ONC’s goal is for any concerns found with certified health IT to be corrected and for certified health IT to function as intended for clinicians, the final rule concentrates on corrective action plans as a means of addressing issues that arise,” he continued. “If a direct review reveals a problem, for example, with certified health IT, ONC will work with developers on comprehensive corrective action plans to address the problems that are found.”
There are several parts of the new rule that will become obvious to physicians, Washington told MedPage Today during the call. “The first will be more information flow; one of three major components of this is transparency,” he said. “On the certified health IT product list a provider would be able to have a good idea whether they are using a tool or getting ready to purchase a tool whether or not that tool has problems or has a great safety rating. That would be pretty evident early on.”
In addition, “the idea of support for products that are being remediated or have a plan to improve them will also be relatively evident to providers,” Washington said. “In particular, what we’ve heard is there is a gap between what may happen in the testing lab and what may happen in the field. So this ability to do more direct oversight and look at how those products work and particularly how they work with the entirety of the physician’s IT system will be more evident more quickly to providers.”
The issuance of the final MACRA rule announced on Friday morning “is as an opportunity to move the focus away from paperwork and reporting toward paying more for what works and giving physicians more freedom and more flexibility to practice better medicine and deliver better care,” Andy Slavitt, acting administrator of the Centers for Medicare & Medicaid Services, said on an afternoon conference call. “We worked alongside physicians to design a portal a one-stop shop and support center to allow physicians to learn about access and even design their involvement in MACRA’s quality payment program.
“For physicians to be successful in value-based care requires technology that’s easier to use, simpler, more connected, less burdensome, and simplifies by delivering exactly what patients and doctors need when they need it, and no more,” he said. “Until technology supports the needs of the workflow, will view certified EHRs as a burden. That’s one reason we reduced the requirements for advancing care information from 11 measures to 5 in the final rule, and added more flexibility so physicians could pick the measures that are right for their practice.”
Advancing care information must become a supporting category, not the main event, he added. “This really should serve to communicate a clear message to clinicians we expect the focus to be on your goals with patients, not your goals with technology. “
The MACRA final rule includes several regulations aimed at making life easier for small practices, Slavitt told MedPage Today. “One of the things we’ve done is people need to actually even report and participate in to have $30,000 in annual revenue with Medicare.” That way, if a practice has fewer than 10 physicians, “more than half won’t need to participate in MIPS at all many of them will be in advanced APMs, will be new to the program, or will just have too low a volume.”
“Second, we reduced the time and cost to participate because we know small practices have fewer resources; we’ve also increased the number of advanced APMs available to small practices, and reduced the amount of risk pretty significantly that a physician would need to take to qualify for an APM.”
Slavitt added that he didn’t really consider the MACRA rule to be truly “final,” despite its name. “This has to be a living, breathing, evolving set of ways we’re going to structure the payment system, because we’re going to learn a lot over the next couple of years. Our goal is that we have a successful, sustainable Medicare program over the long haul, so I suspect we’ll continue to see changes over the next year as we continue to visit clinicians what their priorities are.”
Date: October 15, 2016