Should MU be more mHealth-friendly?

'IT is not solely EHRs and EHR systems, but also includes mHealth, e-Care, telemedicine and eHealth'
By Eric Wicklund
03:56 PM
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A trade organization representing the interests of more than 300 telecommunication companies is urging federal policymakers to incorporate mHealth into future electronic health record certification guidelines. 

The Telecommunications Industry Association called on national coordinator Karen DeSalvo, MD to make sure the voluntary guidelines are flexible enough to allow for "the delivery of healthcare in motion, virtually anywhere and at any time," in a nine-page document TIA sent to the Department of Health and Human Services' Office of the National Coordinator for Health IT.    

"In crafting its 2015 certification criteria (and further editions moving forward) as well as its efforts generally to improve the U.S. healthcare system, we urge ONC to fully appreciate the health information technology ('HIT') ecosystem which is comprised of many technologies, including medical remote monitoring products that are enabled with ICT, namely wired, wireless or mobile," Brian Scarpelli, the TIA's director of government affairs, wrote.

"HIT includes the technologies that touch patients and electronically capture their physiological information and generate valuable data about the person's health. HIT is not solely EHRs and EHR systems, but also includes mHealth, e-Care, telemedicine and eHealth." 

"Embracing the diversity of solutions will allow for innovative improvements at each stage the patient along the continuum of care," he added, urging the ONC to "lay the foundation for robust inclusion of patient-generated health data as a core and menu set criteria for meaningful use Stage 3." 

The TIA also expressed concern that the ONC might be making the certification process too complex. 

"The proposed regulatory pathway for more frequent certification cycles could be the cause of confusion and create unintended consequences," Scarpelli wrote. "Although the 2015 Edition certified EHR technology (2015 CEHRT) is proposed to be voluntary, TIA is concerned that other associated federal programs and resulting regulations could reference or incorporate these voluntary requirements, thus subtly converting a voluntary program into a mandatory requirement." 

In his comments, Scarpelli noted that healthcare providers nationwide are using EHRs to advance patient care, and meaningful use incentives "are absolutely critical to realizing the care transformation objectives of health reform." In that light, he urged the ONC to "structure its 2015 certification criteria in ways that maximize flexibility to permit evaluation of individual applications on their merits, in ways that account for the specific applicant's needs."   

Finally, Scarpelli urged the ONC to consider patient-generated health data – including data gathered in remote monitoring programs and with mHealth devices – "as part of meaningful use." He said the ONC should ensure that, to quality for meaningful use incentives, EHR systems incorporate standards for interoperability with remote patient monitoring devices, services and systems. 

"Clinical evidence has already demonstrated that interoperable remote monitoring improves care, reduces hospitalizations, helps avoid complications and improves satisfaction, particularly for the chronically ill," he wrote.

"So far, the cost savings appear promising: a recent study predicted that remote monitoring will result in savings of $36 billion globally by 2018, with North America accounting for 75 percent of those savings. We believe that the ONC appreciates the value of PGHD to providers, patients, and other stakeholders, and that PGHD should become elemental to the efficient delivery of healthcare."