The OIG is conducting a survey of hospitals who have certified the meaningful use of Electronic Health Record (EHR) Technology, with an emphasis on safeguards that protect the EHR systems from fraudulent access or alteration. A generous hospital compliance officer who has asked to remain nameless has provided me with a copy of the survey tool which can be accessed here.
Topics addressed in the survey include:
- Coding capabilities
- User authentication and access
- Access to EHR by outside entities
- Audit log and metadata features
- Methods for entering physician and nursing notes
- Capabilities for exporting and transmitting EHR documents
- Patient access
- Patient identity management
- Additional features and safeguards.
The underlying thread of the questionnaire looks to determine what each hospital is doing to ensure the integrity of the EHR data gathered, and to identify the barriers to more effective implementation of electronic records.
Meanwhile, back on Capitol Hill, a hearing was held on November 14, 2012 before the House Subcommittee on Technology and Innovation Committee on Science and Technology. The hearing topic was titled: Is ‘Meaningful Use’ Delivering Meaningful Results? An Examination of Health Information Technology Standards and Interoperability. Witnesses were asked to address in their testimony:
What is the goal for health information interoperability under the HITECH Act?
How are Stage 1 and 2 meaningful use requirements and supporting standards advancing us towards this goal?
How have the lessons learned from the implementation of Stage 1 meaningful use requirements and supporting standards been applied in drafting Stage 2 requirements and Stage 3 proposals?
How does the ONC engage Federal agencies and other stakeholders (National Institute of Standards and Technology (NIST), vendors, and providers) in developing the meaningful use requirements and technical standards?
How does the HIT Standards Committee balance the need for common IT standards with the diversity of the healthcare industry? How does the Committee account for technology development and innovation in its standards recommendations?
How effective have HHS and the ONC been in establishing long-term goals and benchmarks for HIT adoption, interoperability, and provision of care?
What recommendations would you make for Federal policy makers as we consider futureHIT policies?
Dr. Farzad Mostashari, HHS National Coordinator for Health Information Technology, presented prepared remarks which can be found here. Dr. Mostashari was cautiously optimistic about the pace of adoption of EHR and the progress being made toward interoperability. He noted that as of September 2012, more than 300,000, more than half of the nation’s eligible professionals, as well as over 75 percent of eligible hospitals have registered to participate in the Medicare or Medicaid Incentive Programs.
Summarizing the lessons learned by HHS to date, Dr. Mostashari stated “By creating standards-based methods for the electronic submission, receipt and processing of health IT, Federal agencies can improve the quality of the data they receive while also reducing the number of expensive, one-off solutions for addressing the varied needs of the stakeholders they serve.” He praised his agency’s collaborations with NIST and recognized the over 6,400 comments received from stakeholders regarding the meaningful use process. He emphasized the efforts to provide new flexibility in definitions, exclusions, a shorter reporting period for the first year of Stage 2, and additional quality measures that account for the needs of many medical specialties to measure and improve the care they provide. He also called attention to the Standards and Interoperability Framework, a Wikipedia-style site for EHR developers, which he described as an example of “government as a platform” - enabled by integrated functions, processes, and tools – for the open community of implementers and experts to work together to develop and harmonize health information exchange standards.
Other witnesses appearing before the committee included Dr. Charles H. Romine, Director, Information Technology Laboratory, National Institute of Standards and Technology; Marc Probst, Chief Information Officer and Vice President, Information Systems, Intermountain Healthcare; Ms. Rebecca Little, Senior Vice President, Medicity; and Dr. Willa Fields, DNSc, RN, FHIMSS, Professor, School of Nursing, San Diego State University.
In his introductory remarks, subcommittee chairman Ben Quayle (R-AZ) noted :
Given our current budget situation, it is vital that these taxpayer dollars are spent effectively in ways that lead to reduced costs and better health care down the road. Nearly four years after the HITECH Act, taxpayers should know what we have to show for it.
The recent survey suggests that the OIG intends to supply Rep. Quayle's subcommittee with a detailed answer to that question.