CMS Outlines Agency Interoperability Goals
In a December 8 blog post, Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure outlined the agency’s recent and upcoming efforts to enhance interoperable data exchange. As part of these efforts, CMS recently announced that it will be exercising enforcement discretion with regard to the payer-to-payer data exchange provisions of the May 2020 Interoperability and Patient Access final rule. These provisions require certain payers to build standardized APIs for exchanging data with other payers, so patients’ data will follow them if they change health plans. CMS has decided that it will not take any action against these payers should they not meet the original compliance deadlines until it can improve the policy through future rulemaking. Brooks-LaSure outlined additional efforts the agency is engaged with, including:
- Exploring what role it should play in managing the healthcare directories patients use to find information on providers;
- Continuing its work with the Office of the National Coordinator for Health IT (ONC) on the United States Core Data for Interoperability (USCDI) standards, aiming to improve data exchange across the healthcare system;
- Exploring how it can utilize ONC’s Trusted Exchange Framework and Common Agreement (TEFCA);
- Looking for new ways to streamline administrative processes, such as prior authorization, and;
- Examining the use of an API based on the HL7 Fast Healthcare Interoperability Resources (FHIR) standard for price transparency.
Administrator Brooks-LaSure’s full announcement of these priorities can be found here.
VA Overhauls EHR Rollout Timeline, Leadership
The Department of Veterans Affairs (VA) announced earlier this month that it has updated its plan to move forward with its systemwide Electronic Health Record Modernization (EHRM) program. VA hopes that the new plan will mitigate numerous challenges documented in the Comprehensive Lessons Learned report submitted to Congress after this year’s strategic review of the program. The announcement comes about a month after the House Veterans Affairs Committee said it did not see enough progress at VA’s first go-live in Spokane, Washington. More than a year after the initial deployment, lawmakers said problems with patient safety, employee morale, and productivity persist in Spokane. According to a survey of the Spokane workforce, nearly two-thirds of employees at the facility said they questioned whether they would continue working at VA due to their experience with the EHR rollout.
VA is now planning a March 5, 2022, EHR go-live date for its hospital in Columbus, Ohio, with a third go-live tentatively scheduled for its facility in Walla Walla, Washington, about two weeks later. The department will then move on to facilities within the Veterans Integrated Services Network (VISN) through 2022. The agency will also be making sweeping reforms to the EHRM leadership, replacing its Office of EHR Modernization executive director position with a program executive director of EHRM integration, beneath whom will report an executive director of the Office of the Functional Champion, executive director of the program management office, and EHRM deputy CIO responsible for overseeing separate aspects of the EHR rollout. VA’s full press release can be found here.
U.S. Coast Guard Electronic Health Record Fully Deployed
In November, the Coast Guard went live at locations in its Pacific Wave and Atlantic Wave, completing full deployment to all Coast Guard clinics and sickbays ashore. MHS GENESIS in now operational at 109 locations, serving approximately 12,000 end users.
Legislation & Politics
FDA Nom Califf Appears for Confirmation Hearing
The Senate Health, Education, Labor, & Pensions (HELP) committee held its confirmation hearing last week for Robert Califf, President Biden’s nominee for FDA Commissioner. Califf, who previously headed the agency from 2016-2017, said one of his top priorities as commissioner would be to devise a better way of generating post-market evidence on drugs by using EHR data and other real-world data (RWD) sources. However, he stressed that the public needs to be able to trust that their data will be used appropriately, saying “I think the most important thing is to develop a system that gives Americans trust that their data can be used, not for someone else necessarily, but for their own benefit.” He continued that, “if I had a heart attack today, I would feel a lot better if I knew how all the other people like me had fared with the different treatments. And so it’s in my interest to share data. But I think we do have work to do to develop a system that Americans will trust to allow this to happen.”
Despite reservations from a handful of Senators, Califf appears to have enough votes to be confirmed by the full Senate. His confirmation would give FDA its first permanent leader of the Biden presidency. Last week, six former FDA commissioners endorsed Califf's candidacy in a letter to the committee, saying he was committed to public service, advancing science, and clinical evidence.
Bipartisan Senate Bill Aims to Increase Social Media Data Transparency
A new bipartisan Senate bill proposes to require social media companies to provide vetted, independent researchers and the public with access to certain platform data. Cosponsored by Sens. Chris Coons (D-DE), Amy Klobuchar (D-MN), and Rob Portman (R-OH), the Platform Accountability and Transparency Act (PATA) would require platforms to share “qualified data and information” with researchers and projects approved by the National Science Foundation (NSF). If passed, the bill would allow independent researchers to submit proposals to the NSF. If the requests are approved, social media companies would have to provide the necessary data subject to certain privacy protections, or else they would be subject to enforcement from the Federal Trade Commission (FTC) and face the potential loss of immunity under Section 230 of the Communications Decency Act. Other transparency mechanisms in the bill include:
- Giving the FTC the authority to require that platforms proactively make certain information available to researchers or the public on an ongoing basis, such as a comprehensive ad library with information about user targeting and engagement.
- Protecting researchers from legal liability that may arise from automatically collecting platform information if they comply with various privacy safeguards.
AMIA News & Notes
A Note from Scott Weinberg
Dear AMIA Members,
As many of you have heard, I will be leaving AMIA at the end of this month and this will be my last Washington Download. During my nearly five-year tenure at AMIA, I have had the privilege of working with countless talented, passionate AMIA members to advance health informatics policy priorities and further strengthen AMIA as a major player in Washington, D.C. When I began at AMIA, I never imagined just how much I would grow and learn from you, whether it was working on a policy Response Team, accompanying you on Capitol Hill, or telling you the latest happenings in informatics policy via this newsletter or a webinar.
I cannot thank you all enough for these past five years.
All the best and happy holidays,
25x5 Steering Committee Releases Final Report
The 25x5 Steering Committee is excited to share the final report from the 25x5 Initiative to Reduce Documentation Burden by 75%, which brought together stakeholders from around the US. The initiative set out 82 prioritized action items for health systems, vendors & policy makers. The 25x5 Summary Report was produced by individuals representing Columbia University, Vanderbilt University, AMIA, and ACMI through support from the National Library of Medicine (NLM).
Did You Miss AMIA’s Public Policy Webinar?
Around the Web
- The Role of Electronic Health Record Developers in Hospital Patient Sharing, JAMIA, December 6, 2021
- Telehealth Became a Lifeline for Older Americans. But It Still Has Glitches, New York Times, December 11, 2021
- COVID-19 Breakthrough Hospitalizations, Kaiser Family Foundation, December 15, 2021
AMIA's Washington Download is your source for health informatics policy news and information from around the Beltway, covering action from the Hill, the Administration and important AMIA collaborators.