CMS Redefines EHR Meaningful Use
At the HIMSS18 Conference, March 3, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma spoke about how far healthcare infrastructure has come in the United States and how far it has yet to go, referring specifically to electronic health records (EHRs). Here is an excerpt from her speech:
We have held meetings in cities across America, and received thousands of letters. And one of the most common complaints we have heard from both patients and providers has been the inefficiency of electronic health records – or EHRs, and the inability of providers to effectively coordinate care for their patients.
Now tremendous progress has been made in the adoption of EHRs. The technology for data sharing has advanced, and data is often shared effectively within a given healthcare system, with inpatient and outpatient doctors in the same provider system able to share and edit the same clinical record.
Despite this progress, it is extremely rare for different provider systems to be able to share data. …
We cannot effectively transition to a value-based system unless we provide to both the doctor and the patient all of the clinical and payment data required at the point of care, to help them mutually make a different and better decision than they could have today.
CMS Puts Patients in the Driver Seat
CMS’ solution to the problem is to empower patients by giving them the tools to manage their own medical records.
“Through the MyHealthEData initiative, this administration is focused on putting patients first, truly first, by empowering them to make cost and quality decisions, and giving them the information they need to prevent disease and improve their health,” Verma said.
The agency’s first attempt at doing this came in the form of Blue Button in 2010, which gave patients access to their claims data in Excel or PDF form. Unfortunately, it failed to tell them what to do with that information. Verma announced the release of Blue Button 2.0, which she said will provide patients with their claims data in a universal and secure digital format, and allow them to take their data and use it in applications designed to help them manage their health, or share it with their doctors.
Blue Button 2.0 contains four years of Medicare Parts A, B, and D data for 53 million Medicare beneficiaries, and provides multiple types of information including prescriptions and primary care treatments.
CMS is asking private plans that contract through Medicare Advantage and the exchanges to release their data and provide the same benefit to their members. And CMS will be working with states on how they can make their Medicaid claims data available to their beneficiaries, as well.
Additional Reading: Patients Take Control of Their Health Data with Blue Button 2.0
No More Information Blocking
CMS isn’t giving up on making EHR use more meaningful, however. Part of the problem, Verma said, is that a provider can prevent patients from getting their data — something called “information blocking.”
Let me be crystal clear, the days of finding creative ways to trap patients in your system must end. It’s not acceptable to limit patient records or to prevent them and their doctor from seeing their complete history outside of a particular healthcare system.
CMS intends to specify what types of information – ideally in electronic format – must be shared by hospitals with a patient’s receiving facility or post-acute care provider.
EHR Meaningful Use Requirements Focus on Security and Portability
CMS is also planning “a complete overhaul” of the Meaningful Use program for hospitals and the Advancing Care Information performance category of the Quality Payment Program. Verma hinted to EHR data security and portability becoming more heavily weighted in the near future.
Already, CMS has finalized for some of its programs the requirement for healthcare providers to use 2015 Edition certified EHR technology (CEHRT) beginning in 2019, which is capable of giving data to patients in a usable and secure electronic format. The Quality Payment Program continues to allow MIPS eligible clinicians to use 2014, 2015 or a combination of the two, but providers who use 2015 CEHRT exclusively in 2018 will receive an additional bonus payment in 2020.
E/M Documentation Requirements Will Be Less Demanding
Verma also said CMS intends to overhaul the documentation requirements of evaluation and management (E/M) codes to allow providers to spend more time with their patients at these visits and less time ticking off required elements in the EHR.
You can read Verma’s entire speech here.