I recently dialed in for a webinar on Accelerating Health Information Exchange hosted by both the Office of the National Coordinator for HHS (ONC) and the Centers for Medicare and Medicaid (CMS).  Presenters included Farzad Mostashari, MD, ScM, National Coordinator for Health Information Technology, ONC, Cindy Mann, Deputy Administrator and Director, Center for Medicaid and CHIP Services, CMS, and Patrick Conway, MD, MSc, CMS Chief Medical Officer, Director of Center for Clinical Standards and Quality, and Acting Director of CMS Innovation (CMMI). 

The government had received over 200 public comment submissions on policies that can strengthen the business case for exchanging information across providers seamlessly and securely.  Here are some takeaways from the webinar:

Highlighted Recommendations from RFI Responders:

• Emphasis on the need for interoperability across the spectrum of care, including LTPAC/behavioral health settings.
• Data elements should be standardized across the spectrum of care.
• Move toward bi-directional information exchange, providing the ability to query for health information.
• Need to make Meaningful Use Stage 2 objectives successful. Provide the tools, validation and feedback needed for making standards successful.

ONC’s Response to the RFI:

• ONC is committed to an incremental, strategic approach to HIE.
• One size does not fit all.
• ONC will continue to advance multi-stakeholder development of standards through its S&I Framework initiatives.
• ONC will align standards for quality improvement, continuing to make the connection between measurement and improvement.

ONC’s Pathway in Response to the RFI:

• A roadmap for HIE already exists. ONC needs to do a better job of communicating this roadmap.
• There is full engagement from the LTPAC/behavioral health community and they wish there was a certification program for their settings of care that builds on the interoperability standards that are already established. ONC is going to move ahead with defining scope (starting small) for “voluntary” certification of LTPAC/behavioral health systems.
• There is a clear business case for admission/transfer/ADT message alerts to alert providers when patients are readmitted to another facility. ONC needs to build upon the learning guide developed by the Hawaii Beacon Community to enable all communities to participate.

CMS’ Pathway in Response to the RFI:

• Health IT and HIE are necessary but not sufficient. CMS will be driving to increase adoption of technology while improving the quality of care for patients.
• CMS will continue to look for existing opportunities to incorporate HIE into payment policies and collaborate with state agencies to encourage HIE programs.
• CMS will continue to incorporate health IT acceleration strategies into Medicaid/CHIP programs.
• CMS will leverage existing CMMI programs to test new payment models and improve care through collaboration with private payers.

ONC/CMS RFI on Advancing Interoperability and Health Information Exchange (March 2013): https://www.gpo.gov/fdsys/pkg/FR-2013-03-07/pdf/2013-05266.pdf

Lantana’s Public Comment Response to the RFI (April 2013): https://www.lantanagroup.com/resources/policy/

ONC/CMS White Paper Summarizing RFI Response: https://www.healthit.gov/sites/default/files/acceleratinghieprinciples_strategy.pdf

Webinar slides: https://www.healthit.gov/sites/default/files/onc_cms_accelerating_hie_webinar.pdf