Even the administrator of the Centers for Medicare & Medicaid Services has trouble getting her hands on a family member’s medical record.
During a keynote address at the Office of the National Coordinator for Health IT’s annual meeting on Friday that focused largely on the need to reduce the regulatory burden on hospitals and physician practices, CMS Administrator Seema Verma relayed a story about how a lack of interoperability impacted her on a personal level.
In August, Verma’s husband, Sanjay Mishra, M.D., went into cardiac arrest at an airport while traveling with the couple’s two children. After a battery of tests, Mishra was eventually discharged from the Hospital of the University of Pennsylvania in Philadelphia. Verma asked the hospital for a copy of her husband’s medical records and test results to take back to his doctor in Indiana.
“The room got really quiet and they kind of looked at each other,” she said. “And it was like, ‘We have no idea what to do here.’”
Verma eventually left with “five sheets of paper and a CD-ROM,” including a discharge summary that didn’t include test results that could provide a baseline for future testing.
“That’s our information and the patient should have that," she said. "When we talk about patient empowerment and patient first, this is what we’re talking about.”
Beyond her personal interactions with health IT, Verma referenced her “nationwide listening tour” where physicians have expressed frustration with the number of reportable measures required by CMS. That feedback led to a new “Meaningful Measures” initiative announced last month to redefine requirements with a focus on those that impact patient care and outcomes.
Part of that burden is tied to issues with EHR interoperability that make it difficult for hospitals to extract and report data to CMS. When one hospital she spoke with said they hired 18 people to collect reporting data, "it turned my stomach," Verma told ONC National Coordinator Donald Rucker, M.D.
But Verma acknowledged EHRs provide new opportunities and efficiencies if they are designed properly, adding that the industry needs to “reset and think about how we go forward.”
She also reaffirmed CMS’s commitment to new technology that will modernize the Medicare program, pointing specifically to the benefits of telehealth. Though she offered no specifics on reimbursement moving forward, her praise for telemedicine technology came in response to Rucker’s question about integrating new tools as part of payment models developed by the CMS Innovation Center, which Verma has vowed to push in a "new direction."
“There are so many opportunities with telehealth, even just around the area of convenience,” she said. “It's not even a rural health issue. I think it is important to rural health, but even in urban areas, it's not easy getting around.”