When CHIME first took on the Hill with the creation of its Policy Steering Committee, members quickly realized they were facing an uphill battle. CHIME wasn’t exactly a known entity in Washington, meaning it would be difficult to secure a meeting with a Congressional aid — never mind an actual Representative.
Six years later, the scenario couldn’t be more different. Not only is CHIME’s viewpoint respected when it comes to issues like cybersecurity, telehealth, and the opioid epidemic — it’s now sought after, according to Michael Martz, who serves on the CHIME Policy Steering Committee. The countless hours spent lobbying, testifying, educating, and listening had paid off.
But the organization has no plans to let up; if anything, the progress that’s been made so far is only fueling the fire, and inspiring leaders to push for more change. During the recent CHIME Advocacy Summit, we spoke with Martz about why policy work is so important to him, where he believes the low-hanging fruit lies when it comes to advocacy, and what’s next.
Gamble: What made you interested in getting involved in policy issues?
Martz: I’ve always been in IT. I’ve only been in healthcare for 10 years. Before that I was CIO for the State of Ohio for six years, and prior to that I was involved in manufacturing and distribution in other industries.
I learned a lot about government and its processes, and the challenges that exist there. But it also got me very interested in public policy. So when I had the chance to get engaged with CHIME’s Public Policy efforts, I jumped right on it.
Gamble: I’m guessing the focus has changed since you became part of the Policy Steering Committee.
Martz: It has changed dramatically. When I first joined, we had very little connection with any of the agencies or legislators. CHIME wasn’t really a known entity in Washington. We were very excited if we had a chance to talk to an aide of a staffer. We never could’ve imagined actually being able to actually talk with a Congressperson.
We have evolved so much. Now, we’re not just respected when we submit opinions — we’re sought out. We’ve been asked to help draft legislation. The agencies, along with members of Senate and Congress, reach out to us to ask our opinions and get guidance on issues. So it’s been a dramatic improvement. We’re very proud of the position we’ve been able to earn and the respect we’ve been able to earn. We hope we can use that to continue to aid the government in doing the right things for the industry.
Gamble: There are so many areas that need attention, one of which is the opioid epidemic. During this event, we’ve heard some talk about the challenges that exist in leveraging prescription drug monitoring programs. What are you finding?
Martz: It is a challenge. All of the original PDMPs started out as websites you had to log into. That’s a lot of extra steps for providers to have to take, and it can take 4 or 5 minutes just to look up one patient. Physicians don’t want to do that, especially in a busy ED.
The ability now to integrate directly with your EHR and be able to access that information in real-time has made PMDP, at least in our hospital, go from one of the most hated to one of the most loved tools.
One thing I’ve learned in healthcare is, any time a physician is asked to go to a second system, it’s going to be trouble. This is one of those examples. We had the same issue with HIEs that originally started out as websites. We learned that until you can get full, end-to-end integration, the value is going to be limited.
Gamble: You bring up an interesting point with HIEs. It seems organizations like CRISP, which is Maryland’s HIE, are the exception rather than the rule. What’s your take on HIEs?
Martz: I honestly expect the HIE market to go through a significant evolution, and I’m looking forward to it. Because we need our systems to automatically connect to an HIE.
Physicians don’t want to go to a second system. We need to make it so that EHRs can go out into the HIE and ask what information is available on that patient, receive it, and show it to physicians on the same screen. It needs to happen immediately, and it needs to happen in the background.
We still have a long way to go to make that possible. Right now we can do that query, but the responses that come back are CCDs, which for the most part, look like a PDF document. They can be many pages long, and no physicians wants to take the time — or has the time — to look through that.
At Mount Nittany Health, we’ve recently had some great progress with being able to extract data out of the CCD; our EHR can now do that directly. A button pops up for providers that says ‘external data available.’ When they click on that, they can see the problem lists, allergies, and medications from CCD, choose what they need, and let the rest go. That has turned out to be very positive for providers.
We’re just now starting to get to that point of connection. But our HIEs are still geographically bound. In Pennsylvania, we have five regional HIEs connected to the state HIE. They can all share information with each other, but the state doesn’t connect anywhere else. So we’re still an island.
It’s silly; we should be able to connect to CRISP. They’re our next door neighbors, and we can’t get to them.
Gamble: And then there’s patient matching.
Martz: Exactly. That’s the core of all this. If we can’t trust that we have the right information, that’s scary. We’ve heard people talk about 95 percent patient matching — that’s not acceptable. That means 1 out of every 20 people are misidentified in the state of Ohio. We have to do better than that.
Other industries talk about quality in terms of number of errors per thousand or million. In the automotive industry they’re shooting for five sigma or six sigma, which is 1 error per 10,000 or 100,000. We’re at one error per 20. And these are human beings. I’d like to see healthcare shoot for something better.
Gamble: It is amazing, though, when you think about the progress that’s been made. It wasn’t too long ago that we weren’t even allowed to talk about patient identifiers.
Martz: I remember my first policy steering committee retreat a few years ago. We were talking about patient identity and trying to find a way to dance around it, and you could feel the frustration in the room. So about halfway through the meeting, we said, ‘That’s it. We’re going to take this head on.’ I think that’s the attitude that drove the creation of the national patient ID challenge.
Gamble: Very cool. So the last question is, what were your overall impressions of the CHIME Advocacy Summit?
Martz: I have loved the energy and engagement we’ve seen, and the access to legislators and administrative folks who’ve come. They understand our issues and they’ve been able to talk at a level that shows that they’re paying attention to what we’ve said, and they’re interested in our opinions, which is very affirming.
I think it’s been spectacular as far as our ability to continue to engage with legislators. I’m very happy with how this has turned out.