My colleague Micky Tripathi testified to NCVHS about meaningful use on April 29. His major points included:
1) We need substantial implementation support and significant resources for health information exchange if we are going to achieve meaningful use. The Regional Health Information Technology Extension Centers (RHITECs) are ideal organizations to assist with these issues.
2) ARRA currently delivers incentive payments directly to clinicians. These payments should be shared with RHITECs, which will assist clinicians with implementation of EHRs. Otherwise, RHITECs will bear the burden/expense of implementation but the physicians alone will be paid for meaningful use.
3) We should use Health Information Exchange activity measurement as a “sufficient statistic” for meaningful use. We should require basic clinical summary exchange through authorized health information exchanges, and require quality measures/public health reporting to be sent to authorized data aggregation entities. If a physician is accomplishing these, then we do not need to measure at the EHR-level because they could not accomplish these things without meaningfully using the EHR.
Also, for completeness, here is the meaningful use statement from the College of Healthcare Information Management Executives (CHIME), also submitted to NCVHS. Sharon Canner from CHIME added a clarification to this testimony:
There is an error in our statement, discovered late in the process. The statement should have read “HL7 Continuity of Care Document (CCD).” CHIME Prefers the CCD; however, it may be a stretch for some hospitals initially.
Tuesday, May 5, 2009
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2 comments:
I like Micky's third point about making HIE part of meaningful use. The only thing I would add to that is having a metric on what types of data are being exchanged.
Summary data may not be sufficient. We should make sure that we don't miss the opportunity to structure meaningful HIE nationally.
And I like Micky's first and second points - about the need for substantial implementation support for not just health information exchange but also for clinician / hospital "certified" EHR adoption.
I strongly believe the RHITECs are ideal for both. However, as important as they are for adoption and attaining "meaningful use", they are woefully underfunded in the HITECH Act.
Dr. H, in a recent webinar you suggested that, perhaps, ONC (through their HITECH reserves) fund the RHITECs (as well as deploy cloud computing....). And, today you wrote that Tripathi suggested tying the RHITECs to the incentive payments. I hope one or both of these suggestions (or others) gets adopted or we might end up with only a handful of these important RHITECs in the entire country!!!
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