HIMSS presses HHS for big-time changes

Society submits recommendations on meaningful use, interoperability and clinical quality measures
By Erin McCann
11:00 AM
Marc Probst
HIMSS executives this week had three big messages for the Department of Health and Human Services and newcomer chief Sylvia Mathews Burwell: They want to see serious changes with meaningful use, interoperability and clinical quality measures.  
On behalf of 57,000 health IT professionals the society represents, HIMSS CEO H. Stephen Lieber and Paul Kleeberg, MD, board director chair, in a Sept. 30 letter to HHS recommended the agency first adjust the meaningful use reporting period to a single three-month quarterly requirement, versus a full year of reporting. This issue is the "most immediate concern," wrote Lieber and Kleeberg, as the inflexible current year-long reporting requirement could very well have patient safety implications. 
"We are facing a situation in which providers may be facing a choice of either ensuring patient safety or complying with regulatory guidelines: because 2015 MU requires too much in too-short a timeframe, rushed IT implementations could result in patient harm," they explained in the letter. "No provider would choose such an outcome; hence, our concern that many may decide to not participate further in the program."
Without "practical and realistic expectations," the goals of the MU program are not going to be realized to their full extent. 
Many CIOs seem to agree. Speaking before Capitol Hill last month, Randy McCleese, CIO of St. Claire Regional Medical Center in rural Kentucky – and joined by a handful of other industry colleagues – called for MU flexibility in 2015. "We're at a point that the things that we're trying to do, it's pushing us over the edge to get to that point," he said. The one-year reporting period is going to require a "tremendous amount of effort and resources that we would prefer go to patient care," he explained before congressional staffers. 
Meaningful use was not the only item on HIMSS' agenda, however. In addition to asking to adjust the meaningful use reporting period, HIMSS executives also recommended HHS consider additional incentives – both federal and private and policy levers to spur interoperability progress industry wide.  
Some industry leaders have even said it's going to take more than incentives. "Where are the teeth with interoperability," asked Marc Probst, CIO of Intermountain Healthcare, who joined McCleese on Capitol Hill last month. "With meaningful use, we had teeth. We had something we could get out there. We had benefits, incentives, and we had penalties." 
Probst, a member of the Health IT Policy Committee, has been one of the most outspoken voices on the topic of interoperability advancement. "It does all come down to these fundamental standards," he added. "We've got to sit down and say,'what's the standard, and how are we gonna move it?'"
The Office of the National Coordinator appears to agree. Karen DeSalvo, MD, national coordinator for health IT at HHS, reiterated ONC's commitment to interoperability, calling it the "top priority," during National Health IT Week last month. 
Aside, then, from interoperability and meaningful use, HIMSS officials also weighed in on clinical quality measures. Specifically? Make the specifications, which have been altered and tweaked by CMS myriad times, a little less confusing. For one, as Lieber and Kleeberg pointed out, CMS has updated every single meaningful use CQM at least twice – and often up to four times, with the current specifications having no indication of changes made. Moreover, these specifications are listed on three different websites, with no "single source of truth," they wrote. 
Overall, the message of the letter was clear: Through the help of HHS policy and its commitment to health IT, serious progress has been made. But there's still much to do, efforts should be ongoing, and the job is never done.