ONC Town Hall: 'We truly know the demands'

ORLANDO—The Office of the National Coordinator for Health IT held a Town Hall meeting at the Health Information and Management Systems Society’s annual conference during which members of the office’s leadership team shared how they are working to advance the national health IT agenda.

The group announced the new eHealth University, “a one-stop shop to access databases and information providers can use to help them implement ehealth initiatives,” said Robert Tagalicod, director of the Centers for Medicare & Medicaid Services’ Office of eHealth Standards and Services. This new offering offers modules that include videos, fact sheets, checklists, guides and webinars to help providers use electronic standards and adopt health IT. The university was vetted and proposed at last year’s conference as a response to requests for more information. The resources are presented in a tiered format to match up with the providers’ progress with ehealth.

Tagalicod specifically referred to Meaningful Use (MU) requirements and the looming ICD-10 implementation date. “We truly know the demands [on providers],” he said. “We will be developing resources throughout the year to help providers meet these milestones.”

This is the year, Tagalicod said, that MU Stage 2 makes healthcare more patient centered. “We encourage providers to give patients access to their health information and provide tools to electronically communicate because that is the key to improving outcomes and care coordination.” It is during Stage 2 that we will see how providers are benefiting from transparency of the information in our healthcare system, he added.

The latest edition of certified EHR technology is in effect, which Tagalicod said helps providers see the benefits of standards and certification, sets new baselines for better interoperability, information exchange and patient engagement, allows providers to share information as patients transition from one care setting to another and includes stronger security.

He also said CMS expects to release a notice of proposed rulemaking this fall for MU Stage 3 and information about corresponding 2017 edition criteria. The final rule with all the requirements for Stage 3 would follow in the first half of 2015.

While the proposed timeline does not delay implementation of Stage 2, he said the extension of Stage 2 allows for more time to prepare for the Stage 3 requirements and for vendors to create and distribute certified technology before Stage 3 begins.

Tagalicod also reiterated that the Oct. 1 ICD-10 implementation is firm.

“We’ve been trying to develop measurements that are meaningful to patients and providers,” said Kate Goodrich, MD, director of the CMS Quality Measurement and Health Assessment Group.

There are, however, many challenges to measuring performance, she said. Her team has been working to determine indicators of outcomes that reflect national priorities. Outcomes usually are influenced by multiple factors. For example, overall hospital readmission rates are too high but the distribution is represented in a wide bell curve. “That indicates a lot of variation. The goal is to narrow the curve and shift it to the left.”

To improve its own performance, Goodrich said her team has been doing Lean culture change and just marked one year. One hundred percent of the measures in MU Stage 2 had defects, she acknowledged, so they hope to dramatically improve going forward.

Alignment of initiatives has been a major area of focus over the last couple of years, Goodrich said. CMS has a task force working on it and she said the agency is much closer to alignment of quality measures but has much more work to do to align policies and submission of data. “The goal is for providers reporting once and receiving credit for all programs. We are getting closer to that but there is more work to do and we cannot do it ourselves. We need input from all of you to realize the ideal state of reporting once.”