Meaningful Use - HIE Disconnect Notes - Part I

As we progress inexorably towards federally-mandated deadlines, attention has focused on the dependency of Meaningful Use Requirements on the broad range of services and organizations collectively bundled under the term "exchange."

States, NHIN, and the private sector are each addressing overlapping parts of these issues - often from different or even competing perspectives. The disconnect between what can be done and what is required to be done was recently highlighted by changes made to the Meaningful Use Final Rule.

In testimony before the House Ways and Means Committee on July 20, 2010, Dr. David Blumenthal carefully and rationally explained how ONC is addressing the short-term realities and the long-term needs.

According to Rebecca Adams in a Commonwealth Fund posting:

Republicans Wally Herger of California and Sam Johnson of Texas specifically questioned why the rules do not require providers to exchange electronic information in a secure way. Instead, officials would require providers only to test systems to see if they are capable of exchanging information during the first stage of the three-phase initiative.

David Blumenthal, the national coordinator for health information technology, responded that exchange systems are not ready to be deployed in all parts of the country. He said that providers should not be penalized if an exchange clearinghouse that must be used to trade information is not operating in an area or if hospitals and physicians have not set up an agreement on how to securely share data.

"It's not fair to individual physicians who are trying desperately to become meaningful users" of health information technology to require them to securely transmit data if the problems are "something they can't control," said Blumenthal.

He noted that the rule does move forward on exchanging information through such requirements as telling physicians to transmit more than 40 percent of prescriptions electronically.

Most importantly, Blumenthal said, the next two phases of the initiative will have more ambitious goals.

"In 2013, they have to be ready to exchange in a much more robust way," said Blumenthal, adding that the administration is "starting where we think industry is, but putting them on notice that they're going to have to move fairly rapidly."

Source: Rebecca Adams. Ways and Means Members Challenge Administration Officials on Health IT. Washington Health Policy Week in Review - July 26, 2010