For every piece of legislation that is passed or revised, an enormous effort takes place. Hundreds of pages must be read and countless meetings and phone calls must be held before recommendations are agreed upon — and even then, a resolution may take years. The reason is simple; the issues healthcare face are incredibly complex. The vision of creating a patient-centered setting in which providers aren’t burdened by technology and are able to provide the highest level of care, and records can be easily accessed, is a utopia, says Mari Savickis, VP of Federal Affairs with CHIME. “If this were easy, we would’ve cracked the code by now.”
But it’s not all doom and gloom — not by a long shot. In the past two months, progress has been made toward CHIME’s longtime goal of easing the Meaningful Use measures, and legislation was passed that will increase funding to combat the opioid epidemic. In this interview, we spoke with Savickis about the policy team’s most pressing matters, and how they’re working to accomplish them.
Bold Statements
Both CHIME and AEHIS are extremely involved in this process. We’re putting together workgroups that will tackle the different areas of focus. There’s still a lot to be done, but we are systematically moving forward.
Let’s help the physicians who are woefully behind because the speed in which the threats are changing is outpacing their ability to keep up, and they’re under-resourced. We can get them the help they need.
We’re looking at this through the lens of technology and data. How do we try to create policies that leverage technology to improve care? And so we’re emphasizing the use of clinical decision support to provide physicians with better information at the point of care.
It was certainly encouraging, but there’s still so much to be done. We recognize that the needle the government has to thread in moving to APIs, while balancing the burden on clinicians, is a difficult one.
Gamble: I’d like to talk about the letter CHIME recently sent in response to CMS’ call for improvement activities under MIPS, with the two areas of focusing being opioid abuse and cybersecurity. Let’s start with cybersecurity. In the letter, CHIME referred to the Health Care Industry’s Cybersecurity Taskforce report, which was released in the summer of 2016. What’s the latest on this — have some of the recommendations been put into place?
Savickis: Let me start by providing some background. There are two organizations — the Government Coordinating Council (GCC) and the Sector Coordinating Council, which refers to the private sector (and includes healthcare). Think of them like two circles. Where they overlap is the Joint Cybersecurity Working Group. It’s headed by Greg Garcia, who is the executive director.
In terms of where we stand with the report, Greg recently kicked off a refresh of the SCC, citing the need to breathe ‘new life’ into the private sector from a cybersecurity standpoint. It started with a meeting last month, where several industry representatives met and were asked to take ownership of this and start moving the needle. Part of that involves starting to operationalize the recommendations that came out of the Task Force report.
Both CHIME and AEHIS are extremely involved in this process. We’re putting together workgroups that will tackle the different areas of focus. There’s still a lot to be done, but we are systematically moving forward.
Gamble: Can you talk a little more about the Joint Cybersecurity Work Group – how it’s organized and what the focus is right now?
Savickis: Within the Joint Cybersecurity Working Group, there’s a subgroup called 405D. It is, rather aptly, named after a provision in the Cybersecurity Information Sharing Act of 2015, which called for a set of best practices to help create a NIST framework in the healthcare sector. Over the past year, the group has been working to develop those best practices, which will be released in draft form and pilot-tested this year.
That’s where we are right now. Once those are finalized, we strongly recommend that CMS give credit to clinicians for implementing at least 75 percent of them. We think it makes complete sense.
Gamble: It seems like a no-brainer to tie this to some form of incentive.
Savickis: It is. If you look at where the existing revenue streams are, this is low-hanging fruit. I just makes sense to put funds toward this. We’ve been asking CMS for three years to give credit for engaging in cybersecurity practices. Now we’re taking it a step further and recommending 405D practices. And we’re not the only ones doing it. We want CMS to take cybersecurity seriously, and treat it as a patient safety issue, because these attacks are a threat to patient safety.
What’s encouraging is that the Cybersecurity Task Force is co-chaired by CHIME member Theresa Meadows (who is SVP and CIO at Cook Children’s), and Emery Csulak, who is CMS’ Chief Information Security Officer. And so we’re hoping they can work together to push this forward. Let’s help the physicians who are woefully behind because the speed in which the threats are changing is outpacing their ability to keep up, and they’re under-resourced. We can get them the help they need, and we don’t have to reinvent the wheel to make that happen.
Gamble: The other improvement activity, of course, is focused on the opioid epidemic. Can you talk about how CHIME is approaching this?
Savickis: This issue is so important to us. We established the Opioid Task Force, which is co-chaired by two CIOs, Jim Turnbull (University of Utah Health) and Ed Kopetsky (Lucile Packard Children’s Hospital), who lost his son last year to addiction. We had the kickoff meeting in January, and the second during the HIMSS conference.
We’re looking at this through the lens of technology and data. How do we try to create policies that leverage technology to improve care? And so we’re emphasizing the use of clinical decision support to provide physicians with better information at the point of care. It’s already built into certified EHRs, so it’s really a no-brainer. Organizations should be using CDC Guideline for Prescribing Opioids for Chronic Pain, and they should be using mobile apps at the point of care.
The money is already there; these are existing funding streams. When you’re experiencing a national crisis, which we are, you need to leverage all the tools in our toolbox.
Gamble: There’s also ePrescribing, which has been shown to help determine whether a patient has been prescribed opioids. But this presents workflow challenges that prevent some clinicians from using it.
Savickis: It does, and so we help them overcome those challenges by providing incentives. We’re not saying it should be mandated, but for those who do the hard work to navigate through the technological and financial maze, we need to sweeten the pot.
Gamble: What were your impressions of the initial kickoff meeting, in terms of what you saw from both providers and vendors?
Savickis: There’s an enormous appetite to make progress. We had several Congressional staff representatives in attendance, and they were able to outline some of the activities going on in Washington, DC.
At this point, we’re still refining what steps we need to take from an advocacy standpoint. We received feedback with the Senate Finance Committee and the HELP (Health, Education, Labor and Pensions) committee, and we’re working on crafting a response to their requests. We’re only about a month and a half into this, and so we’re still fleshing that out. We also submitted a letter to the FCC, which we had never done before, asking them to double the funding for rural healthcare. Their proposed rule was around telemedicine and how it can be leveraged to improve care in rural settings. We believe that if we’re able to reach more people, we can better address the opioid epidemic.
We’re looking for opportunities where we can help with this on the federal side, but we recognize a lot of this has to come from the bottom-up. And we’re trying to navigate that piece. The next action item will be to come up with the steps we’ll be taking in the next 30 days, 60 days, and 90 days.
Gamble: Right. Finally, the last issue I wanted to touch on was the passage of legislation to lessen some of the burdens of Meaningful Use. I know CHIME has been carrying the flag on this for so long — what are your thoughts on this?
Savickis: It was certainly encouraging, but there’s still so much to be done. We recognize that the needle the government has to thread in moving to APIs, while balancing the burden on clinicians, is a difficult one. What we’ve heard from our members is that moving the thresholds that have been outlined achieving MU stage 3 is very challenging, and so I don’t think we’re going to see those thresholds remain. The first shot across the bow is going to be the IPPS rule, which is coming out in April.
But the question with this administration is, between TEFCA and MU, how do we move to a place where you can drive interoperability and put patients at the center of care, while also minimizing the burden on clinicians, and allowing them to maximize face-to-face time with patients, all while having seamless access to data? It’s almost a utopia. If this were easy, we would’ve cracked the code by now. It’s extremely complex.
We believe we’ll get there, but it’s going to be a long road.
Share Your Thoughts
You must be logged in to post a comment.