The CMS and the Office of the National Coordinator for Health Information Technology are absolutely committed to using health information technology as a foundation for healthcare system payment and delivery reform.
That was the message put forth Tuesday morning at the HIMSS annual conference and exhibition in New Orleans: First, in a talk by acting CMS Administrator Marilyn Tavenner, then in a news conference given by National Coordinator Dr. Farzad Mostashari and in an HHS news release
Part of this multitiered message distribution effort included the release of a soon-to-be-published-in-the-Federal-Register CMS request for information (PDF)
, in which the CMS and ONC announce their interest in recommendations for how they can use their “policy levers” to further drive health information exchange “to support more person-centered, coordinated, value-driven care.”
“Our focus has to be interoperability this year,” Tavenner said.
Tavenner noted that there will be no additional rules released this year pertaining to the federal meaningful-use electronic health record incentive program and that the focus will be on implementation of the Stage 2 rule and determining how Stage 3 should look. Later, Mostashari said that the Stage 2 final rules “are set.” And, according to the release, HHS' focus will be on “implementing rules that define what data must be able to be exchanged between health IT systems, including how data will be structured and coded so that providers will have one uniform way to format and securely send data.”
While IT adoption has increased rapidly among healthcare organizations, the groups that represent them—such as the American Hospital Association and the American Medical Association—have written
the CMS and the Office of the National Coordinator asking for a little time to catch their breath. And it appears that this message has been heard.
“2013 is going to be a busy year,” Tavenner said. “I realize we're giving you a lot of work to do.”
Included on the to-do list is preparation of the adoption of the ICD-10 set of diagnostic codes in October 2014.
“Are we going to delay ICD-10? The answer is no,” Tavenner said in an announcement that received audience applause.
Tavenner said the CMS responded to the AMA's concerns about ICD-10 by pushing back the adoption date by one year. She described that as a good compromise, “but it was a one-time visit to that compromise.”
Mostashari said physician adoption of ICD-10 will be aided by EHRs that bake in the Systematized Nomenclature of Medicine-Clinical Terms, or SNOMED-CT, code to provide more granular data descriptions of patient conditions that will help in deciding the most appropriate code to use among the 200,000 or more codes available within ICD-10.
He also said the government will “double down” on its efforts to educate physicians on ICD-10 and added that vendor support will be needed in this effort.
Other priorities for this year include enhancing the Blue Button Initiative
that allows veterans and Medicare beneficiaries to access their medical records online and “underscoring program integrity.” Tavenner explains that this will be done in part through the use program audits aimed at “learning what's working.”
Market forces are also part of this process, Mostashari said.
“I'd like to see usability drive the market,” Mostashari said, adding that he still sees systems with “circa 2005” user interfaces. “I just can't see these vendors doing well when there are so many other choices.”