Federal health information technology
policymakers are looking to transition away from requiring providers to meet a specific batch of clinical quality measures to a more flexible approach that includes crediting providers for their own quality-improvement programs.
“Giving all the kids a C-minus doesn't make them better students,” said Dr. Jacob Reider, deputy national coordinator and chief medical officer for the Office of the National Coordinator for Health Information Technology at HHS. Reider was addressing the opening morning session of the 23rd annual Physician-Computer Connection Symposium in Ojai, Calif. The conference is hosted by the Association of Medical Directors of Information Systems, a professional association of physician informaticists.
“We'd like to shift the conversation away from a set of quality measures” and move instead to a focus on ways to improve the quality of care, Reider said. “This is going to take us a while to make this turn, but it is a very important turn.”
During a question and answer session that followed, Reider was asked how ONC was considering driving the change.
“We'd like to hear from you all; where do you measure things that aren't part of any federal program?” he said.
The Stage 1 criteria under the federal EHR
incentive payment program, which includes a menu of clinical quality measures providers had to meet to achieve meaningful use and qualify for federal electronic health-record incentive payments were “put together very quickly with the best of intentions,” Reider said.
But the government is aware of complaints from providers and EHR system developers—including two delivered to him from the audience at the event—that meeting the incentive payment program's meaningful-use requirements is drawing time and energy away from their other IT system and quality-of-care improvement efforts.
The meaningful-use program had 816 discrete data elements that need to be collected, he said, but even so, “Some would argue that we're looking for our car keys under the streetlight” by limiting the measures that count for meaningful use to a specified list.
Going forward, ONC's role will be to “empower others to develop great measures,” he said. Disruption to provider workflows from gathering data for and reporting on those measures should be minimized.
How that policy shift will be implemented remains an ONC work in progress, Reider said. Follow Joseph Conn on Twitter: @MHJConn