Impact Insights

Week in Review 3/20/15

A hearing held by the Senate’s Health Education & Pensions (HELP) Committee focused on federal EHR incentives and problems with EHR interoperability. Senators from both parties expressed concerns about meaningful use, with criticisms ranging from the penalties many providers are facing to the fact that the program doesn’t include long term care or behavioral health facilities. Healthcare IT News reports that concerns about EHR vendors were also raised, such as the high costs charged for interfaces and the fact that there is not really a business incentive for vendors to collaborate. The aftermath of the hearing also made news, with Cerner and athenahealth taking to Twitter to criticize comments made by an Epic representative during the hearing about the CommonWell Health Alliance, which both Cerner and athenahealth are members.

To watch the hearing in full, click here.

Impact Advisors’ Thoughts: This is as much attention we can remember lawmakers giving to the meaningful use program – and EHR interoperability in general – in a long time. The criticisms aren’t new, but the hearing is still important because Congress (unlike HHS) actually does have the power to fundamentally change any part of the EHR incentive program – including completely “rebooting” it and starting over, as one Senator suggested. With the proposed rule on Stage 3 just published, it will be interesting to see how (or if) this hearing influences the debate about future meaningful use requirements.


The permanent “doc fix” bill introduced in the House and Senate yesterday includes a provision that would make it a “national objective” to achieve “widespread exchange of health information through interoperable certified EHR technology nationwide by December 31, 2018.” Under the language attached to the bill, HHS would be required to establish metrics to determine if interoperability is achieved, and if it is not, HHS would have to submit a report to Congress with recommended actions (such as penalties). Hospitals and EPs in the meaningful use program would also be required to demonstrate that they have not “knowingly and willfully taken action (such as to disable functionality) to limit or restrict the compatibility or interoperability of the certified EHR technology.”

Impact Advisors’ Thoughts: Reports are that Congressional leaders are optimistic about passing a permanent doc fix bill (which would repeal Medicare’s controversial Sustainable Growth Rate formula and avoid scheduled payment cuts to physicians), but nothing has been voted on yet. To be clear, the language attached to the bill about interoperability doesn’t really offer a solution; it really only lays the foundation for possible consequences (penalties, de-certification, etc.) if problems with data exchange continue. The fact that the language was included is definitely significant though, and indicates Congress may increasingly try to get more involved on this topic.


More than half of nurses report that they have witnessed a medical error due to lack of data sharing among medical devices (!), according to a new Harris PollClose to three quarters of nurses surveyed agreed that coordinating the data collected by medical devices is burdensome, and 46% indicated that potential errors are “extremely” or “very likely” when manually transcribing information from one medical device to another. Almost half of nurses who responded (47%) felt that working with medical devices was “one of the least productive ways they spend their time.”

Impact Advisors’ Thoughts: Interoperability between medical devices (and between medical devices and EHRs) does not always get as much attention as interoperability between enterprise EHR systems, but it is no less important – and it is definitely a huge challenge for many hospitals today.


In case you missed it… The American Telemedicine Association has posted a very helpful state-by-state list of telemedicine legislation, including summaries of each bill and the current status!