The College of Healthcare Information Management Executives is asking the federal government to make sure that providers are achieving an adequate level of compliance with current meaningful-usecriteria before upping the ante and creating more stringent guidelines for eligibility to receive electronic health-record systems incentive payments under the American Recovery and Reinvestment Act of 2009.
CHIME to ONC: Check current MU compliance before moving ahead
The Ann Arbor, Mich.-based association for healthcare chief information officers made the request in its comments (PDF) on the proposed Federal Health IT Strategic Plan released by the Office of the National Coordinator for Health Information Technology at HHS last month.
CHIME repeated an earlier request that Stage 2 meaningful-use objectives, now being considered by the ONC and the CMS, "not be implemented before 30% of eligible hospitals and eligible professionals have achieved Stage 1 objectives," according to a news release.
The privacy rights—or the limits on those rights—of patients to control the flow of their own medical records via electronic health-information exchange, also were at issue in the CHIME letter, which noted that the "ONC needs to further define how consent management should be handled, and it must address the responsibility of patients, physicians, hospitals and insurers on how consent will be stored and transmitted through health information exchanges."
In 2002, HHS amended the privacy rule under the Health Insurance Portability and Accountability Act to no longer require patients' consent for the disclosure of their medical records to providers, health plans and claims clearinghouses for treatment, payment and a broad category of uses called "other healthcare operations." Since then, privacy advocates have pushed for restoration of this requirement, and technology has been developed to enable systems to place controls on the flow of records, including so-called "granular" controls of specific, sensitive data elements, such as diagnoses or prescription drug records.
The President's Council of Advisors on Science and Technology, in a report on healthcare IT issued in December, also discussed creating a health exchange language and architecture with meta-data tags that could be attached to medical records or their parts to better enable search but also contain patient consent directives.
CHIME urged the ONC in its letter "to establish standards for a national privacy regulatory environment that would apply to all health-information exchange." It also called on the Office for Civil Rights at HHS, which has enforcement responsibility over the HIPAA privacy rule, to re-examine federal pre-emption "in a way that facilitates, not hinders, health information exchange across jurisdictional boundaries."
The 1996 HIPAA statute permits states to pass more-stringent privacy protections than those in the federal law.
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