(The 10th Annual National Health IT Week is being held October 5-9, 2015. Join us for this collaborative forum where public and private healthcare constituents work in partnership to educate industry and policy stakeholders on the value of health IT for the U.S. healthcare system. With Meaningful Use now providing the way forward, there is no better time for the health IT community to come together under one umbrella to raise national awareness! www.HealthITWeek.org)
Senators Sheldon Whitehouse (D-RI) and Bill Cassidy (R-LA) introduced a bill on Tuesday, October 6th known as the Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act of 2015. The legislation is meant to establish a system for rating various health information technology systems so that consumers have a place to compare the many products available on the market today.
Currently, health IT product standards are left up to the vendors as they compete to win the medical doctors attention, trust and are rewarded by earning the business. Establishing a clear rating system across the healthcare industry will hold these products accountable and confirm that they are performing as intended.
In a press release regarding the TRUST IT Act, Senator Cassidy, who is a physician himself, stated, “this bill implements better coordination in the electronic health records system.” Earlier this year, in June, Cassidy chaired a Senate Health Education Labor and Pensions (HELP) Committee hearing to discuss how to improve physician interaction with electronic health record systems.
Senator Whitehouse added, “This bill will establish important safeguards to prevent systems from underperforming and will grade them on their performance…”
The system will be created through a transparent process, including input from stakeholders such as healthcare professionals, hospitals, health IT vendors, health information exchanges (HIE), and others involved in the health care industry. Consumers will be able to view and compare health IT products based on the criteria of security, usability, and interoperability. Performance will be key in determining how the products are rated. These criteria will be further discussed during a 60-day public comment period, after which feedback will be assessed for further modifications before a final rule is made.
Once developed, the system will offer a maximum three star rating: a one star rating indicates the product is less than satisfactory, a two star rating indicates it is satisfactory, and a three star rating indicates it is excellent. Products that receive a one star rating will be subject to “a corrective action plan…to improve the health information technology rating within a timeframe that the Secretary determines appropriate.” Vendors may also face fines or decertification if they are unable to improve their ratings.
In addition to developing a rating system, the bill will also include interoperability standards for product certification and prevent health IT vendors from blocking information or including non-disclosure clauses in their contracts. One year after the TRUST IT Act, vendors must demonstrate the following:
- They have not taken any action that could be interpreted as blocking health IT information.
- They will not participate in practices intended to limit usability, interoperability, and security of health IT.
- The product is capable of sharing and exchanging health IT information without the use of “special effort.”
A group consisting of patients, providers, and payers, the Health IT Now Coalition is supportive of the legislation. “Time and again data show that if consumers are given accurate information they make better decisions…a new rating system will help hospitals, doctors, and other healthcare providers better choose systems that will help deliver more effective, lower-cost care to patients.”
The TRUST IT Act, if passed, will transform the current health IT system to one dependent primarily on the reliability and quality of a product, with industry politics playing a much smaller role.
Government agencies getting into Health IT, at least as far as Electronic Health Records are concerned, offers a long list of both pros and cons… here are a few to start the discussion:
- Government oversight in Health IT might include a “Minimal Standard” application of performance to meet specific guidelines.
- Obviously stated, patient safety would be paramount in meeting minimal standards.
- Medical specialty specific workflow and corresponding medical codes for the clinic could be set to ensure the patient’s medical needs were being met.
- Medicare and Medicaid agencies would have a clearer oversight and mitigate the number of possible fraudulent claims.
- Most incorporated industries now have a set of standards and as a result, product improvements have been made and benefiting the consumer.
- The year 2009 was significant to the EHR industry with the American Reinvestment and Recovery Act, commonly known as ARRA. This is when the term Meaningful Use was initiated and concrete steps were taken to establish the base standard for clinics to comply with patient safety and documented encounters. The Centers for Medicare and Medicaid (CMS) is an integral part of Meaningful Use for the coding and billing practices for reimbursed medical services.
- Government intrusion into Healthcare IT could grow to levels that would halter or, even stop entirely the forward progress and production of Electronic Healthcare Records as a product or industry.
- The US Government should maybe not get involved by dictating the direction of EHR, stifling creative product improvements and thwarting consumer voting via spending.
- The government might dismiss greater individual consumer (Licensed Medical Providers) involvement by dictating the standards of excellence driven by a non-medical agenda.
- Each medical provider is an individual with an individual set of skills as demonstrated by license issued to practice medicine by the states and federal governments. If the government issues the license, the government should trust the provider to select the product that best fits their needs to provide care and service to patients.
Let’s keep the EHR market free of additional governmental influence. If the government were to set the standards and determine what they might see as the proper workflow, this would take the individuality and bedside manner from the provider out of the patient visit.
I suspect the government involvement with EHR ratings could be insulting to the medical profession. We think that in the free market, medical doctors ought to set their own standards of excellence by purchasing contracts from the EHR vendor of their choice, best fitting the needs of their clinical practice needs without influence from a government rating system. The TRUST IT act may end up as the worst combination of all online review sites and government bureaucracy, undermining the expertise of qualified professionals and what had been rapid development in an openly unhindered and competitive environment.
Authors: Chris Ferguson & Apoorva Anupindi
To learn more about Bizmatics Executive Vice President Chris Ferguson, visit our leaders page.