Senate panel seeks Stage 3 meaningful-use delay

A key Senate leader said his committee will push to delay implementation of the Obama administration's Stage 3 rules for meaningful use of electronic health records.

Lamar Alexander (R-Tenn.), chairman of the Health, Education, Labor and Pensions Committee, said last week that the delay will be one of several recommendations his committee will make to the administration about EHR regulation.

The American Medical Association and the Medical Group Management Association have sought a delay in Stage 3 rules, which aim to expand sharing of patient records between providers. The rules are due to go into effect in 2017.

Other recommendations the Senate committee is likely to make to the Obama administration will cover standards clarifying that patients own their own health data; interoperability; heightened security requirements for patient data; and more user-friendly EHR systems, Alexander said.

If legislation is ultimately needed to get those recommendations implemented, they likely would be rolled into the Senate version of the House's 21st Century Cures Act legislation. Alexander said he expects the Senate version to be drafted and voted on early next year.

In March, the CMS issued proposed rules for Stage 3. This final stage requires providers to send electronic summaries for 50% of patients they refer to other providers, receive summaries for 40% of patients who are referred to them, and reconcile past patient data with current reports for 80% of such patients.

Healthcare providers are concerned that the Stage 3 rules put them at the mercy of other providers in terms of compliance.

According to a new analysis by Niam Yaraghi, a fellow at the Brookings Institution's Center for Technology Innovation, if providers do not send electronic summaries, the medical provider who was supposed to have received them will have failed to comply with the rulemaking.

“This leads to a situation in which even tech-savvy providers will not be able to fulfill the requirements of the third stage of the meaningful-use program, regardless of their intentions and efforts,” Yaraghi wrote.

Alexander's news briefing came after his committee's hearing on “information blocking.”

“There is substantial evidence that some organizations are intentionally setting up barriers between their systems and other systems, overcharging or creating technical or legal barriers to providers who want to access information through the system they've purchased, or both,” Sen. Patty Murray (D-Wash.) said at the hearing.

Witnesses at the hearing generally opposed new regulations to address the blocking issue.

In April, the Office of the National Coordinator for Health Information Technology issued a report stating that most allegations of information blocking involve provider business practices rather than problems with EHRs themselves.

“Attempts to redress the root causes of information blocking must address the unwillingness of some providers and their EHR partners to share and exchange data,” Dr. David Kibbe, a senior adviser to the American Academy of Family Physicians, said at the hearing.

“That unwillingness,” he added, “originates in the current business models of some healthcare provider organizations, and the healthcare industry in general, wherein fee-for-service payment creates disincentives for sharing of health information and rewards information hoarding, or at least the delay of timely information exchanges.”