The primary focus of CHIME’s Advocacy Program is to advance the role of CIOs and other senior healthcare IT leaders by providing educational, collaborative, and advocacy programs to improve the quality of care. Through our CHIME Policy Chats, healthsystemCIO.com is partnering with the organization to provide a forum to educate CIOs on advocacy efforts, learning opportunities, updates on legislative and regulatory issues, and other key issues. The discussions feature Sharon Canner, senior director of advocacy, and Jeff Smith, assistant director of advocacy for CHIME.
Chapter 1
- Wrapping up 2012
- Stage 2 – “A second crack at defining MU”
- CHIME’s two-pronged approach to educating Congress
- The value of CIO input
- Spotlighting health IT success stories—“The industry is clamoring for best practices”
- How payment reform is driving HIT adoption
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I think if we look at the finalization of Stage 2 Meaningful Use, that certainly takes the cake as probably the most significant health IT development. It is a second crack at defining Meaningful Use, and I think we really saw a maturity process.
We have expanding groups of CIOs who choose to participate in work groups and provide a significant amount of input in weighing proposals and how it would affect them, and we communicate this back to ONC or CMS.
We did hear from various committee members questioning, for instance, the investments made so far in the incentives, and whether that is really producing the interoperability that is so desirable for this program. I think what we’re trying to say to them is that this is a growth process. This is a maturing. This is an evolution.
ACOs and associated payment reform initiatives are really driving health IT adoption in ways that MU isn’t. And I think that between MU and a lot of the payment reforms, you see the synergy and the interoperability that a lot of folks on Capitol Hill are asking about.
That’s really where a lot of our members drive home the value of CHIME to the federal government and to other governments at the state level, in that they can speak directly to the challenges and the opportunities that exist there.
Gamble: Hi Jeff and Sharon, thanks so much for taking the time to talk with me today.
Canner: Good afternoon, we’re delighted to be with you today.
Gamble: Okay, so we’re just all jumping into 2013. Even though it’s been a few weeks, it takes an adjustment for everyone. But before we really get into that, I wanted to talk about 2012 for a minute and get your feel on what you think were the most significant developments in health IT last year.
Canner: Sure, let me kick off. Certainly from the development standpoint, it’s been wide-ranging, from everything from pilots and demonstrations that were done through the standards and interoperability framework, to the Supreme Court’s decision to uphold the Affordable Care Act. Then you have the launch of some 50-plus state Medicaid incentive payment programs, and certainly health IT saw a lot in terms of evolution during 2012. Looking a little bit further, if you look at the various pillars of HITECH — EHR adoption rules, attestation and registration numbers, and REC — you see the kinds of really broad-based positive trends that I think most of us had hoped to see. I think if we look at the finalization of Stage 2 Meaningful Use, that certainly takes the cake as probably the most significant health IT development. It is a second crack at defining Meaningful Use, and I think we really saw a maturity process.
And finally, I would sum it up by saying health IT stakeholders — and this includes providers, vendors, and patient advocates — seem to have a better understanding of what the rules mean. And also from all of their input responding back to the government, I think this gained experience has really led to actually a more complex rule, and the reverberations we’re going to keep feeling I think well beyond 2013. So there is certainly a lot to chew on as we look back on 2012.
Gamble: Yeah, and when we think about when the Stage 2 proposed rules were first announced, that was the beginning of the year and probably, to a lot of people, it seems like that was five years ago. So definitely a whole lot happened in 2012 that’s going to shape what happens this year.
Canner: Exactly.
Gamble: There is, like you said, so much to touch on there. It is such a wide ranging question. But let’s look ahead and talk about 2013. From CHIME’s perspective, what is the biggest focus and what are the biggest goals for this year?
Canner: Each year, CHIME Public Policy holds a retreat, which we did in November, and our leadership identified five areas on which we are going to focus all of our efforts in this coming year. This is not in order of priority, but these are the areas we’ll be focusing on throughout the year, and they begin with Meaningful Use, and second is HIE evolution and interoperability. Number three is patient matching, which is something we have been pursuing for a number of years. Number four is clinical quality measurement across value-based programs, and five is accountable care. Whether it’s for congressional hearings or meetings with regulators, we believe CHIME will have a unique perspective to contribute on these issues. So we’ll be focused on them as a way to garner in CHIME member involvement in our public policy programs.
We have a two-pronged approach in Washington. The first is to educate members of congress on the value of health IT and the important role that CIOs play in improving care, and also to lend CIO experience and expertise to the regulators and other policy makers as they look to develop new rules or programs. As we have found, particularly in responding to requests for information and pending rules, having the CIO input on their experience really is invaluable. More and more, we have expanding groups of CIOs who choose to participate in work groups and provide a significant amount of input in weighing proposals and how it would affect them, and we communicate this back to ONC or CMS.
This year, we’re going to spend a great deal of time educating new members of congress to tell them, of course, about CHIME, but also making them aware of the various programs where health IT is essential. As you know, a lot of these areas were expanded coming out of the Accountable Care Act. I’ll just mention sort of a brief list: ACOs, medical homes, and of course, Meaningful Use. We are trying to bring all of these together and to further underscore education, we’re planning some kind of event on Capitol Hill on late spring as a way to provide this education beyond our individual Hill visits. So I think that really about sums it up from where we are as we go forward into 2013. These five areas will be guiding our policy effort.
Gamble: One of the things I wanted to touch on a little bit more was talking about educating members of congress about health IT. It seemed a little concerning to me that last fall, we were starting to see more politicians speak out and question the funding that’s going to health IT. Is this focus just to make sure that they realize everything that goes into these programs and the importance of health IT? Is that one of the main focuses?
Canner: That’s a very good point. We did hear from various committee members questioning, for instance, the investments made so far in the incentives and whether that is really producing the interoperability that is so desirable for this program. I think what we’re trying to say to them is that this is a growth process. This is a maturing. This is an evolution. This doesn’t happen overnight. Stage 1 was setting up the structure or beginning the motions, and Stage 2 is moving on exchanging health information. I think we’re asking for patience and better understanding of what this process is about. If this weren’t so complex, we would have done it long ago. With new members of Congress, it does become essentially starting all over again in a lot of instances, and then reeducating some who have been there for some time. So you’re absolutely right on the education objective.
Gamble: Sure. And even if members of congress are fairly educated about it, there’s so much that goes into an EMR implementation that I don’t think people can understand if they haven’t been through it. I certainly haven’t, so I don’t understand all of the complications and workflow issues that have to be worked out. Like you said, it’s far from an overnight process.
Canner: It is, and interestingly, we often attempt to spotlight a particular hospital or CIO from that member’s district — he or she may have actually visited with that hospital — to help them connect the dots. ‘Oh yes, I’ve been there. I’ve seen that demonstration. That’s what you’re talking about.’ That sometimes is the case.
Gamble: Yeah, sure. I can see the value in that. So let’s talk a little bit about ACOs, because that seems like something a lot of organizations are looking to ramp up this year. Is that something that you’re hearing?
Canner: We are. There are more ACOs being stood up, and our efforts are to speak with CIOs to find out their responses and their experiences, and then try to communicate that, which again demonstrates the value of the investments that congress has made in health IT and of course on ACOs. Excellent point.
Smith: I would just add that under our five big priorities, accountable care is listed. One of the reasons we didn’t add ‘organization’ at the end of that is because we wanted to make sure to include things beyond accountable care organizations, like patient-centered medical homes and population management programs. And so I think over the next year you’re going to see a lot more activity in that area. We’re very supportive of that, because in a lot of ways, ACOs and associated payment reform initiatives are really driving health IT adoption in ways that Meaningful Use isn’t. And I think that between Meaningful Use and a lot of the payment reforms, you see synergy and you do see the interoperability that a lot of folks on Capitol Hill are asking about. So I think over the next year, we certainly hope to see gains there, and I think it will continue to be a prime focus for our advocacy and policy efforts.
Gamble: Is that something where look for model organization or an organization or state where they really seem to be doing well with this, and then using that as a model?
Smith: Absolutely. One thing that the industry as a whole is constantly clamoring for is best practices. And I think there’s a fairly robust infrastructure in Washington and elsewhere through various think tanks and academic organizations that have a pretty good catalogue of best practices, but a lot of times, organizations look toward the government to try and highlight what’s going on and what’s working, and vice versa. A lot of times, the government is asking organizations like CHIME and others to provide instances where things are going on, and that’s really where a lot of our members drive home the value of CHIME to the federal government and to other governments at the state level, in that they can speak directly to the challenges and the opportunities that exist there.
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