GOP senators rip federal health IT programs
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April 17, 2013 01:00 AM

GOP senators rip federal health IT programs

Joseph Conn
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    Six Republican senators have produced a 28-page white paper that is sharply critical of the Obama administration's handling of the federal health information technology programs under the 2009 stimulus law, saying they need to be “recalibrated to be effective.”

    The paper alleged five “key implementation deficiencies”: a lack of a clear path toward interoperability; concerns about health IT increasing healthcare costs and not helping to control costs as previously estimated; a general lack of HIT program oversight, citing an HHS inspector general's report from last December; patient privacy and security risks; and concerns about whether providers can afford to maintain their federally incentivized healthcare technology long term.

    The senators are Lamar Alexander (R-Tenn.), the ranking member of the Senate Health, Education, Labor and Pensions committee, fellow committee members Richard Burr (R-N.C.); Mike Enzi (R-Wyo.); and Pat Roberts (R-Kan.); and Senate Finance Committee members Tom Coburn (R-Okla.) and John Thune (R-S.D.).

    In addition, the six have asked HHS Secretary Kathleen Sebelius to “provide a detailed written plan to address the concerns” raised in the document, “REBOOT: Re-examining the Strategies Needed to Successfully Adopt Health IT.”

    Finally, the senators have prepared a separate letter addressed to health IT stakeholders and members of the public, asking for feedback on issues raised in their white paper and “any areas of concern, and potential solutions” to improve implementation of the health IT provisions of the American Recovery and Reinvestment Act of 2009. The letter to stakeholders was either mailed or e-mailed to “stakeholders we regularly work with or have heard from in the past,” a spokesperson for Thune said in an e-mail.

    In their three-page letter to Sebelius, the senators requested HHS provide a list of “every contract or task order awarded to perform work related” to the ARRA's health IT provisions, known as the HITECH Act. They also asked for progress updates or the findings of three ONC contracts: one with Mathematica Policy Research, tasked with building a model of the linkages between the various federal health IT programs; another with the National Opinion Research Center at the University of Chicago, to evaluate state health IT programs; and a third with the American Research Institute on the effectiveness of the federally funded Regional HIT Extension Center program.

    They also asked for information about the ONC's Beacon Communities program, which is slated to spend $250 million over three years among 17 regions across the U.S. that were already actively demonstrating leadership in health IT adoption and use. The senators asked for evaluations of the Beacon Communities, including how many “will have to reduce their standards in Stages 2 and 3” of the federal EHR incentive payment program “to avoid penalty payments?”

    They also asked for copies of internal ONC reports on program implementations and on the effects of the federal HIT program on communities with health disparities. They asked for responses in writing by June 16.

    “Congress and the administration need to work together to 'reboot' the program to accomplish the aims of meaningful use and interoperability and ensure appropriate stewardship of taxpayer dollars in the process,” the white paper said.

    Peter Garrett, director of communications for the ONC, pointed to some facts not included in the white paper.

    “As far as adoption goes,” Garrett said, “we've got more than 85% of hospitals” registered for the EHR incentive payment program “and more than 75% receiving payments. “There are also more than 388,000 eligible professionals who have registered. In terms of adoption, I think these are really strong numbers.”

    Regarding interoperability, Garrett said the focus of Stage 1 of the program was to promote health IT adoption, but in Stage 2, the program is “raising the bar” for interoperability. For example, the meaningful-use requirements for interoperability in Stage 2 include, in addition to electronic prescribing requirements continued from Stage 1, electronic reporting of clinical quality measures, the exchange of care summaries and allowing patients to electronically transmit and download their own records.

    In addition, the ONC has focused on creating a standards and interoperability framework, laying “a foundation to increase interoperability” in the coming months and years, Garrett said.

    The regional extension centers, he said, have “created a network of support that we believe will continue” for small providers.

    Follow Joseph Conn on Twitter: @MHJConn

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