CHIME urges feds to apply existing policies to HIE acceleration

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The College of Healthcare Information Management Executives believes that the U.S. Department of Health & Human Services should extend processes developed under the eRx and Electronic Health Record Incentive Payment programs to accelerate and improve health information exchange and interoperability among providers.

In a letter to Centers for Medicare & Medicaid Services Acting Administrator Marilyn Tavenner and National Coordinator for Health IT Farzad Mostashari, CHIME President Russell Branzell (pictured) and board chair George Hickman say that the current certification processes for both programs have heavily impacted the adoption and use of health IT. The letter is in response to a request for information issued last month by HHS.

"As a policy lever, the impact of certification criteria developed for Meaningful Use cannot be understated," they say. "Thus, CHIME recommends HHS extend the concept toward the health information exchange market, via standard interfaces, standard methods for isolating sensitive information, standard means to securely transport patient care information, standard ways to accurately identify patients, standard protocols for tracking consent, etc.

They urge HHS to pay particular attention to patient data-matching, calling it "dangerous and costly" for hospitals.

"As exchange increases from other treating providers outside of their primary practice or system, patient data-matching errors and mismatches will become exponentially more problematic and potentially dangerous," Branzell and Hickman say. "While technologies, architectures and strategies exist to mitigate errors, CHIME encourages CMS and [the Office of the National Coordinator for Health IT] to dedicate substantial resources to this foundational challenge."

CHIME also recommends that CMS and ONC:

  • Keep the strategies flexible
  • Avoid mandating participation in certain types of exchanges (statewide, nationwide, etc.)
  • Focus on mandating transport, vocabulary and content standards
  • Implement interconnections between HIEs as a requirement for certification
  • Examine regulations that could potentially inhibit exchange

Industry stakeholders have long expressed concern about interoperability, including the cost of data sharing, inadequate security, and lack of vendor readiness. Patients also have questioned the ability of HIEs to protect their data, whether they can restrict the sharing of their data to others--such as payers--and if they can keep their data out of HIEs entirely.

To learn more:
- here's CHIME's letter (.pdf)

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