CHIME: Beware too-great EHR expectations

Although the College of Healthcare Information Management Executives (CHIME) supports the ongoing development of EHR capabilities and acknowledges their importance in broader changes to the Office of the National Coordinator for Health IT  (ONC) strategy, caution should be exercised so as not to expect EHRs to do too much, too fast, "such as accommodate multiple languages and disabilities,” wrote Richard Correll, president and CEO of CHIME, responding to the ONC's request for comments on the proposed Federal Health IT Strategic Plan.

CHIME stated it ultimately supports ONC’s goals, but also seeks refinements to increase the likelihood for adoption of IT by healthcare providers.

The Ann Arbor, Mich.-based organization urged the ONC to ensure confidence and trust in health IT, particularly in facilitating the exchange of patient information to support care delivery. CHIME recognized the need for patient confidentiality and privacy protections, but said that need must be balanced against the ability to exchange health information when necessary.

“Several of the objectives listed throughout the plan foresee the fluid exchange of the right information, at the right time, for the health and safety of patients,” CHIME commented. “To make sure this information is shared responsibly, ONC must further define how consent management should be handled, and it must address the responsibility of patients, physicians, hospitals and insurers on how consent will be stored and transmitted through health information exchanges (HIEs).”

The process of gaining consent from patients for the exchange of their health information also must support the exchange of information derived from patients’ personal health records (PHRs), CHIME said. This is crucial to ensuring that “information between patients and their providers—no matter the source—is accurate, secure and furthers the goal of improved care.”

CHIME also urged ONC to act to ensure that laws keeping health information private are more uniform from state to state.

“CHIME urges ONC to establish standards for a national privacy regulatory environment that would apply to all HIE,” the comment letter said. “We consider this yet another example of how the current HIPAA pre-emption policy creates problems by essentially allowing geographic variation in privacy rules, which complicates compliance and makes it more costly.”

CHIME further pressed the Office for Civil Rights (OCR) to re-examine its stance with respect to federal pre-emption “in a way that facilitates, not hinders, health information exchange across jurisdictional boundaries.”

The organization also reiterated its request that Stage 2 meaningful use objectives not be implemented before 30 percent of eligible hospitals and eligible professionals have achieved Stage 1 objectives, and called for more alignment among the Department of Health and Human Services’ (HHS) regulations affecting the timeliness of patient access to information. The timeliness standard under the HIPAA provisions “is significantly different from that under the EHR meaningful use regulations recently adopted by HHS (30 days for information maintained onsite vs. three business days),” CHIME noted.

 

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