Thoughts on the Senate HELP Committee's draft legislation

An important bill could help bridge the gap between meaningful use as we know it and the future.
By John Halamka
09:21 AM
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On Jan. 20, Senators Alexander and Murray released the Bipartisan Senate Health Committee Staff Draft of Bill to Help Improve Health Information Technology for Doctors & Their Patients.

Here’s a summary.

This is a really important bill. Why?

It includes legislative changes that will help reshape/evolve meaningful use.

You may have seen the recent confusing press about Stage 3 meaningful use. CMS Administrator Andy Slavitt tweeted from JP Morgan that meaningful use as we know it will end since we’ve lost the hearts and minds of clinicians.

A few days later, Karen DeSalvo, MD, and Andy Slavitt posted this blog, which suggested Stage 3 is still in force.

What happened? Here’s my opinion:

Andy Slavitt is outsider at CMS. He was being was being very genuine when he said that meaningful use has run its course based on what he has heard from stakeholders. However, there are folks at CMS who want the current path of meaningful use to continue. Also, there are current laws on the books that make change difficult – ARRA/HITECH still applies to hospitals.

MACRA provides a path for eligible professionals to move from the highly prescriptive check boxing of meaningful use to alternative payment models based on outcomes, but providing a path for hospitals requires new legislation.

The HELP Committee draft legislation may provide that path.

It requires HHS to reduce burden, a key point in revising the meaningful use construct. It also enables data collection by a team of caregivers, and accelerates national infrastructure for provider directories and patient identifiers.

It forms a consolidated HIT Policy and Standards Committee, which is very reasonable.

Policy and technology are two sides of the same coin. Interoperability requires technology standards supported by governance and data use agreements. In the past, the Policy Committee and the Standards Committee worked using a waterfall methodology – policies were created and then standards advice was requested.     The notion of one group, chartered to produce policy and technology in parallel, makes sense.

In some ways, the draft legislation echoes the standards harmonization work done by the Health Information Technology Standards Panel (HITSP), which I chaired from 2005-2009. Here's the HITSP charter.

There is only one part of the draft legislation that I think is truly unhelpful – creating a government sponsored rating system for healthcare information technology. I cannot think of another industry in which the government provides a "Yelp"-like function. A better approach is for private companies, such as KLAS to provide the research the market demands. Last week, the combined HIT Standards and Policy Committees agreed by consensus that the government should NOT develop and maintain a comparison tool, or expand the Certified Health IT Product List to serve as a comparison tool.

I will watch this draft bill very closely. I’m hopeful that Congress will give Andy Slavitt the support he needs to end meaningful use as we know it.