The Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT, in issuing a response to their Request for Information (RFI) on accelerating health information exchange (HIE) and interoperability Wednesday, released their principles and strategy, taking an "incremental yet comprehensive" approach and steps to "encourage" widespread "voluntary" use.
"This is complicated but we are making progress," National Coordinator for Health IT Farzad Mostashari said on a webinar announcing the strategy. "It took a decade for ATMs to be interoperable, and they only use seven data fields."
Strategies outlined on the webinar by ONC and CMS included:
- The use of payment models such as accountable care organizations to drive HIE
- Advancing HIE across providers, including those not currently in the Meaningful Use Program, such as long term and behavioral health providers
- Incorporating HIE requirements into Medicaid
- Introducing reimbursement changes, such as a proposed complex care management fee conditioned on an electronic summary of car record exchange, which is in the proposed physician fee schedule
CMS also is working to align the Meaningful Use program with other reporting programs so that hospitals and physicians only have to report to CMS once, according to CMS Chief Medical Officer Patrick Conway, who also is the acting director of the Center for Medicare and Medicaid Innovation.
ONC and CMS received more than 200 comments on the RFI, which had been published March 7.
Mostashari said that there was a lot of confusion about HIE and interoperability, and wanted to reiterate that there is a road map for information to be exchanged and used, but that there needed to be a better way to communicate it. He also said that while many states and communities are setting up regional HIE networks, "there is no central database of all healthcare information, and I doubt there will be."
There was no indication of any new regulations that would mandate national standards for interoperability.
ONC has already stated that it will not issue regulations regarding HIE governance, opting instead to provide voluntary guidance.