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March 7, 2018

The White House just announced 3 new interoperability initiatives. Here's what you need to know.

Daily Briefing

    Read Advisory Board's take on this story.

    CMS Administrator Seema Verma on Tuesday announced three new initiatives to address the health care industry's interoperability issues and improve patients' access to their EHRs.

    Over the past decade, the federal government under CMS' meaningful use programs has spent billions of dollars to encourage providers to digitize patients' medical records. While the program has been largely successful in getting providers to adopt EHRs, the health care industry has struggled to find ways to securely share those records with both patients and other providers. According to the Associated Press, health care data are often stored in different formats, and many EHR companies have created systems that do not communicate with competitors—in part because they have little incentive to make it easy to share data with providers who use their competitors' software.

    About the initiatives

    To address those barriers, Verma in a speech at HIMSS unveiled three new initiatives that focus on consumers, Medicare beneficiaries, and reducing providers' regulatory burdens.

    1. MyHealthEData initiative

    President Trump's son-in-law Jared Kushner, who directs the White House Office of American Innovation, will lead the MyHealthEData initiative that spans multiple federal agencies, including HHS and the Department of Veterans Affairs.

    According to AP, Verma provided few details on the new initiative, but a news release suggests it aims to give patients more control over their health records, allowing them to take their records "with them from doctor to doctor, or to their other health care providers." According to the release, "Patients will be able to choose the provider that best meets their needs and then give that provider secure access to their data, leading to greater competition and reducing costs."

    In an interview, Verma said the administration is working on a timeline for the initiative, and that the agency will detail aspects of new requirements intended to improve interoperability and make it easier for patients to access to their EHRs in upcoming rules, Bloomberg reports.

    2. Blue Button 2.0 initiative

    Verma in her speech also announced the Blue Button 2.0 initiative to make it easier for Medicare beneficiaries to securely access and share their medical data. According to the release, more than 100 organizations have joined the initiative and are working to develop applications to bring new tools to beneficiaries.

    In her speech, Verma called on Medicare Advantage insurers to follow CMS' lead and improve beneficiaries' access to their Medicare data.

    3. Overhauling CMS programs to increase focus on interoperability, value-base care

    Verma also argued that patients must be able to access and use their data to make informed decisions about their care in order to enable the industry's shift to value-based care.

    As such, Verma said the agency plans to:

    • Create quality measures related to interoperability for its value-based payment models;
    • Re-examine its Medicare and Medicaid meaningful use programs for eligible hospitals and MACRA's Quality Payment Program for clinicians to increase the focus on interoperability and reduce barriers to compliance; and
    • Take new action to prevent information blocking (Tozzi/Tracer, Bloomberg, 3/6; Alonso-Zaldivar, AP/Washington Post, 3/6; Dickson, Modern Healthcare, 3/6; CMS fact sheet, 3/6; CMS release, 3/6).

    Advisory Board's take

    Naomi Levinthal, Practice Manager and Tony Panjamapirom, Senior Consultant

    The MyHealthEData initiative announced by CMS Administrator Seema Verma at HIMSS is not a surprising move for the agency, since it has made it a policy goal to enable patients' access and use of their data. We will be very interested to see the mechanics of how CMS wants to implement the initiative. If the agency plans to rely on application programming interfaces (APIs), providers have told us they are hopeful that APIs can help address interoperability challenges with the movement of patient data. But our members have also expressed many concerns over API privacy and security, and also around provider workflow to access the data that has been brought into their system.

    Verma also touted CMS' plans to overhaul the EHR Incentive Program (i.e., Meaningful Use) and the Advancing Care Information requirements in the MIPS program. However, there's scant detail available on how they will give the program yet another extreme makeover, after it's already been significantly overhauled several times in the past few years.

    We anticipate more clarity about the program overhaul in late spring, when CMS is expected to release proposed rules for the 2019 Inpatient Prospective Payment System and for MACRA's Quality Payment Program. While we await further information from CMS, two things are clear:

    First, this announcement doubles down on the implementation and use of 2015 Edition Certified EHR Technology. The overarching goal of CMS' Meaningful Use overhaul is to promote interoperability and patient access to electronic data via open APIs, and those are functionalities supported by 2015 Edition Certified EHR Technology, and align with new Stage 3 Meaningful Use measures.

    Second, this announcement doesn't indicate CMS plans to eliminate the EHR Incentive Program or MIPS. Rather, it shows that the agency wants to shift the focus of these programs toward more "Meaningful Measures," in conjunction with Verma's Meaningful Measures Initiative.

    If you're at HIMSS, check out our remaining Advisory Board expert-led sessions on Wednesday and Thursday, and email ITSuiteEvents@advisory.com to schedule time with one of our experts at the conference.

    To get the latest on MACRA, join our "Get Straight on MACRA" webconference on Tuesday, March 27.

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