CHIME Policy Chat: Are Vendors Ready For Stage 2… Or Not?

The primary focus of CHIME’s Public Policy 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, we hope to inform CIOs about advocacy efforts and learning opportunities; provide updates on legislative and regulatory issues; and educate them on what CHIME is doing to help shape the implementation of federal and state policies. The discussions feature Sharon Canner, senior director of advocacy, and Jeff Smith, assistant director of advocacy for CHIME.

Chapter 1

Chapter 2

• MU 2 & vendor readiness
• Gathering data — “ONC is a very data-driven agency”
• Broadening the “limited view”
• Call to action for CIOs — “Policy change takes work”
• Grassroots efforts targeting standards
• CHIME’s new leader

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Bold Statements

Increasingly there is the concern that vendors either won’t be ready with certified products, or that they may have certified products available, but their clients won’t be in the queue to get that upgrade in time for all of the process and change management that has to happen.

I think time will tell if CMS and ONC can come together on a plan to enable the kind of flexibility that we think is needed.

ONC is a very data driven agency. But right now, they can only see so far. They can only see which vendors have been used to successfully attest to Meaningful Use, and they can see which vendors have met certification criteria for 2014. But that is a very limited view.

It’s not just pressing a button and instantly it happens, like you drop in your new Microsoft version and it works — not when patients are at stake and you have a whole system to sort of recalibrate and to put together.

CHIME is now headed by a former CIO, Russ Branzell who will be charging the CIOs to get more involved with public policy.

Gamble:  In speaking to CIOs, we hear a lot of concerns about vendor readiness and about making sure that providers have time to upgrade to the new software. Obviously these are pretty huge concerns, and they’re not going away anytime soon. I’m sure just hearing the talk about the push to extend Meaningful Use 2 is very encouraging for CIOs and other leaders.

Smith:  Yes — I hope so, anyway. We’ve been talking about this with our members easily for the past five, six, even seven months, and I think that increasingly there is the concern that vendors either won’t be ready with certified products, or that they may have certified products available, but their clients — the providers and hospitals — won’t be in the queue to get that upgrade in time for all of the process and change management that has to happen to be Meaningful Use-ready in 2014.

One thing we did was during NHIT week, we held a briefing for senate staffers that really tried to communicate to them what the process looks like from beta testing to implementation to being Meaningful Use-ready, and then finally going a step beyond that to really optimizing the EHR technology. We were really trying to give senate staffers a sense of what that entails. I think generally one of CHIME’s core objectives as an organization is to help CIOs educate other CIOs on how to implement EHRs and how to optimize the technology.

Looking at the political landscape — and while this is nowhere close to a done deal, I think again, this is a very big win for those of us who have been working on it — it’s a step in the right direction. I think time will tell if CMS and ONC can come together on a plan to enable the kind of flexibility that we think is needed.  That being said, over the coming months, we’re certainly hopeful that we can try to generate internally some more convincing data and some more convincing evidence for the federal agencies on the need to do this. ONC is a very data driven agency — as well as it should be. But right now, they can only see so far. They can only see which vendors have been used to successfully attest to Meaningful Use, and they can see which vendors have met certification criteria for 2014. But that is a very limited view in terms of actual readiness for Meaningful Use.

I think there are a couple of things, hopefully in the pipeline that CHIME will be doing to try and make that picture of readiness more visible. I know that some of our members are actually working on implementation guidelines and timelines separate from CHIME, but it’s something they’ll certainly be sharing with CHIME members and something that we can help amplify as an organization to the wider health IT community.

Gamble:  That’ll certainly be valuable because we’re talking about so many different factors when we talk about vendor readiness and when a certain product is going to be ready. Just even saying ‘ready’ is a loose term, and so being able to clarify that and give more specific information is something that’s certainly needed.

Canner:  It’s not just pressing a button and instantly it happens, like you drop in your new Microsoft version and it works — not when patients are at stake and you have a whole system to sort of recalibrate and to put together. It’s been important to have CIOs who are willing to come into Washington and to have that dialogue with the staff on the Hill. They are very, very interested in hearing what it really takes. It is a challenge for CIOs who have a very busy day job to pick up, fly to Washington and spend that time, but they realize that it’s very important to make this case and to affect policy change. Policy change takes work.

Gamble:  As far as CHIME’s strategic planning, is there anything else you can share in terms of where CHIME is going to be focused?

Canner:  As I mentioned earlier, we’ll continue with our interaction with the Hill. One of the strategies that was important in trying to get the attention of the Hill was to have our CIOs sign a letter to their senators to really make the case. It’s all part of a grassroots effort to encourage a particular senator to sign onto the letter. We’re focusing on grassroots efforts and how all of that works, which really gets to a major education campaign informing CIOs how to get more involved. So member engagement is something we continue to work on, as well as looking at areas such as standards.

Obviously, CIOs have long been involved with standards and have called for standards; moving forward we will be continuing to figure out how all of that gets rolled up. And so a lot of good discussions came out of our deliberations and I’m sure you’ll hear more about that in the coming weeks. I hope that gives you a little bit of a flavor of where we are.

Gamble:  Certainly. The last thing I wanted to touch on was the upcoming Fall Forum — just in terms of what CIOs can expect in terms of the opportunities available for getting involved in advocacy efforts and networking with other CIOs, especially those who are really are involved with legislative issues.

Canner:  One change of course, as you know, is that CHIME is now headed by a former CIO, Russ Branzell who will be charging the CIOs to get more involved with public policy. And we’ll be pointing to some of the successes that have already transpired this year in sessions that really will mirror and take up some of the issues we’re already talked about today. One issue we did not talk about was audits. There will be a session called ‘Surviving A Meaningful Use Audit: Hear From Those Who Have Been There,’ during which CIOs will share their experiences.

Another session will also focus on a report on patient consent and data matching. Our StateNet workgroups have been providing input on how these issues are treated in their various states. And in another session Dr. Farzad Mostashari — who will no longer be the national coordinator — will be joining us as a private citizen. I think that will be a really good opportunity to have further dialogue with someone who has been just a magnificent leader on national health IT. And certainly we’ll have the usual networking events and focus groups. It will be a very, very active four days in warm Scottsdale, Arizona.

Gamble:  Certainly. I’m glad that you’ll be covering audits; that’s one of the issues that we hear a lot. You’ve probably seen the same thing, but just in seeing the expression on someone’s face when that topic comes up, we know that this is an area where a lot of people are hungry for knowledge and best practices. I’m sure it’s a session that will be pretty heavily attended.

Canner:  Yes, absolutely.

Gamble:  Okay, well thank you for all the information about NHIT Week. It sounds like it was a really very successful event, and we’re looking forward to the Fall Forum.

Canner:  Terrific. We’re really delighted to chat with you.

Gamble:  Thanks so much, and I look forward to seeing you guys.