CHIME Calls For Policy Changes To Improve Data Exchange

CHIME is urging HHS to extend the concept of certification to the health information exchange marketplace to advance interoperability and improve data flow. In comments submitted Thursday in response to a request for information (RFI) from CMS and ONC, CHIME pushed for a strategy that enables local flexibility, while leading stakeholders in the development of specific technical standards, services, and policies that solve core problems, reduce costs and complexity, and facilitates nationwide interoperability.

Released in early March, the RFI sought feedback on the role payment system reforms such as ACOs or bundled payments can play in improving interoperability, and whether changes to Conditions of Participation might be leveraged to encourage further exchange.

“CHIME believes that the certification process, developed under the EHR Incentive Payments program, has had a major impact on the adoption and meaningful use of health information technology,” the organization stated. “As a policy lever, the impact of certification criteria developed for Meaningful Use cannot be understated. Thus, CHIME recommends HHS extend the concept toward the health information exchange market, via standard interfaces, standard methods for isolating sensitive information, standard means to securely transport patient care information (i.e., Direct), standard ways to accurately identify patients and standard protocols for tracking consent.”

CHIME also voiced its support for payment model changes underway at CMS and the CMS Innovation Center (CMMI) as a way to enhance interoperability by creating a stronger business case for providers to exchange data. “CHIME believes CMS should continue the evolution of payment policies towards pay-for-value and away from fee-for-service,” the letter said.

The organization also urged caution in applying blanket mandates to participate in exchange, stating, “While we believe any model of accountable care delivery cannot be successful without robust technology usage, CHIME believes that forcing miscellaneous exchange through requirements for participation, receipt of incentive payments, or avoidance of payment adjustments is a serious proposition — one that needs broad input from stakeholders.”

The hot-button issue of patient identification was addressed as well, with CHIME noting, “As exchange increases from other treating providers outside of their primary practice or system, patient data-matching errors and mismatches will become exponentially more problematic and potentially dangerous. As stated in a survey of CHIME membership from May 2012, ‘Unintended injury or illness attributable to patient data-matching error is a considerable, and growing, problem in this era of health information exchange. And with a substantial portion of CIOs involved with HIEs that use differing approaches to data matching, we can expect the inconsistency and variability inherent to healthcare IT systems to persist — and become more endemic — without national leadership and consistent standards.’ While technologies, architectures and strategies exist to mitigate errors, CHIME encourages CMS and ONC to dedicate substantial resources to this foundational challenge.”

To read CHIME’s response to CMS and ONC in its entirety, click here.