LAS VEGAS—The Centers for Medicare & Medicaid Services (CMS) announced several new initiatives on Tuesday designed to give patients unfiltered access to their health records and punish organizations that engage in data blocking.
The agency also plans to roll out a “complete overhaul” of the Meaningful Use program for hospitals and the Advancing Care Information category of the Quality Payment Program, CMS Administrator Seema Verma told HIMSS18 attendees. Changes to the program will be included in proposed payment rules for physicians and hospitals released later this year.
“We’re moving away from giving credit to physicians for just having an EHR to actually making sure that it is focused on interoperability and giving patients their data,” Verma told reporters after her speech.
CMS is launching two specific initiatives designed to give patients access to their records. MyHealthEData, which is led by the White House Office of American Innovation, incorporates agencies throughout the Department of Health and Human Services (HHS), as well as the Department of Veterans Affairs, that will focus on breaking down the barriers limiting access and improving interoperabiltiy.
“The time is now to align every facet of the federal government and the private sector to ensure information is communicated and shared seamlessly,” Jared Kushner, who directs the White House Office of American Innovation, told the HIMSS18 crowd. “Simply put, interoperability is about our shared bottom line: saving lives.”
Part of making that data available to patients means cracking down on instances of data blocking. The Office of the National Coordinator for Health IT is tasked with defining information blocking, but Verma called out the practice in her speech, indicating CMS “will not tolerate this practice anymore.” She later told reporters that CMS plans to leverage payment regulations and its existing contracts with insurers to crack down on data blocking.
The second initiative, Blue Button 2.0, builds on the work of the previous administration to give Medicare patients access to claims data and allow app developers that meet prescribed standards to plug into that data set. The initiative will “create an ecosystem where tech innovators are competing to serve Medicare beneficiaries and their caregivers, finding better ways to use their claims data,” Verma said.
The primary focus for CMS is providing an API framework to allow the private sector to derive value from often complicated claims data. The agency is currently accepting applications for Blue Button 2.0 for U.S.-based developers with concise privacy and security language. Organizations that serve Medicare beneficiaries will have a distinct advantage in that application process.
“That’s going to be the challenge of private sector and innovators—to be able to take the data that is out there and make it meaningful and understandable,” Verma says.
Digital health companies are eager to close those gaps, according to John Doerr, an investor with Kleiner Perkins Caufield & Byers. In a press call on hosted by CMS, he called the new initiatives "the first in a series of data quakes we'll see across the country."
He added that he expects entrepreneurs to "double the number of healthcare apps over the course of the next five years" because of the CMS initiatives.