The Trump administration is attempting to put patients in control of their own health data and to spur healthcare innovation as part of its broader efforts to cut red tape in the federal government.
The Centers for Medicare and Medicaid Services announced on Tuesday at the HIMSS18 conference in Las Vegas the launch of the MyHealthEData initiative, which CMS Administrator Seema Verma claimed is the first time any administration has set in motion a coordinated initiative to truly make patients the focus of the healthcare system by using the federal government's full authority to ensure providers and insurers give patients control of their medical records.
The goal of the government-wide MyHealthEData initiative is to make the patient “the center of our healthcare system,” Verma said. The effort will be led by the White House Office of American Innovation with participation from CMS, the Office of the National Coordinator for Health IT, the National Institutes of Health, as well as the Department of Veterans Affairs.
Despite the federal government’s investment of more than $30 billion in incentives to get providers to adopt electronic health records, Verma told HIMSS that “doctors are still faxing medical records back and forth.” In addition, she lamented that patients don’t have access to their complete EHR and can’t share their complete medical history with their physician.
“While we’ve made progress in getting paper medical records into electronic systems, those records stay with the doctor or hospital and these systems don’t make it easy for patients to access and to share their records—so, today, we are announcing the MyHealthEData initiative which is all about giving patients control of their health records,” said Verma.
According to Verma, patients might be able to obtain some information from providers within a healthcare system but there’s no way to aggregate that data, and when providers don’t have all the necessary information at hand they repeat tests driving up costs and causing medical errors—which threaten patient safety.
She said the new MyHealthEData initiative is in alignment with President Trump’s “Cut the Red Tape” initiative, noting that in October 2017 CMS launched the Patients Over Paperwork effort designed to reduce regulatory burdens on providers to enable them to spend more time on clinical tasks.
“The MyHealthEData initiative will enable doctors to spend more time with their patients and less time looking at their computer once our policies go into effect,” added Verma. “It will declare to hospitals and insurers that the practice of holding patients hostage in their systems and blocking their data will no longer be tolerated.”
When it comes to information blocking from providers or health IT vendors, Verma said CMS will not tolerate the practice anymore. “Let me be crystal clear, the days of finding creative ways to trap patients in your system must end,” she pledged. “It’s not acceptable to limit patient records or to prevent them and their doctor from seeing their complete history outside a particular healthcare system.”
As part of the MyHealthEData initiative, Verma said CMS will be announcing a “complete overhaul” of the Meaningful Use program to save time and costs, including the following actions:
- Streamlining the Medicare and Medicaid EHR Incentive Programs for eligible hospitals and critical access hospitals and the Quality Payment Program for clinicians (part of MACRA) to increase the programs’ focus on interoperability and to reduce the time and cost required to comply with them.
- Prioritizing the use of quality measures and improvement activities in value-based care and quality programs that lead to interoperability.
- Taking steps against information blocking, as required by law by requiring hospitals and clinicians under some CMS programs to show they have not engaged in data blocking activities.
- Streamlining policies around documentation guidelines for Evaluation & Management codes (which doctors use to bill Medicare for patient visits) to modernize documentation requirements and reduce clinician burden.
- Specifying what types of information—ideally in electronic format –must be shared by hospitals with a patient’s receiving facility or post-acute care provider.
“Ensuring the security of healthcare data will be an absolute requirement in order to avoid negative payment adjustments or to receive an incentive payment,” promised Verma. “Our new direction will not only reduce time and costs but will also be laser-focused on increasing interoperability and giving patients access to their data across all of our programs.”
In her remarks, Verma also announced the launch of Medicare’s Blue Button 2.0—a new and secure way for Medicare beneficiaries to access and share their personal health data in a universal digital format—and called on all healthcare insurers to follow CMS’s lead and give patients access to their claims data electronically.
“Over the course of the year, we will be reexamining all of our partnerships and relationships with health insurers to find ways to make it clear that we are serious about putting patients first and giving them control of their records—not merely in words but in deeds,” committed Verma.
In addition, she said MyHealthEData will facilitate the flow of information fostering innovation among health IT developers who will invent new technologies that will help patients understand their medical data. “This is not just about basic access,” Verma declared. “Just as importantly, this will empower patients to be true consumers of healthcare which will ultimately drive competition and lower costs.”
Verma said that CMS believes that the future of interoperability centers on the development and implementation of open application programming interfaces (APIs) to allow third-party app data access and integration empowering patients.
APIs are part of the 2015 Edition of Health IT Certification Criteria, which requires certified EHRs to demonstrate the ability to provide a patient-facing app access to the Common Clinical Data Set via an API, as well as the final Meaningful Use Stage 3 rule requiring certified EHR technology to provide an API through which patient information can be viewed, downloaded and transmitted to a third party.
“Imagine a world in which your health data follows you wherever you go and you can share with your doctor—all at the push of a button,” concluded Verma. “Imagine if, in turn, your doctor didn’t have to spend so much time faxing records and staring at a computer during an appointment. Imagine if you could track your medical history from your birth throughout your entire life, aggregating information from each health visit, your claims data, and the health information created every second through wearable technology. Imagine if patients could authorize access to their records to researchers from all over the country.”
Patients are demanding this change, Verma declared, and “this administration will pull every lever to create a healthcare information ecosystem that allows and encourages the healthcare market to tailor products and services to compete for patients.” For those bad actors who continue to create barriers to patient access to their health data, she encouraged them “in the strongest way” to accept change because “those practices will come to an end.”
In response to the MyHealthEData initiative, the Health Care Transformation Task Force (HCTTF) joined the CARIN Alliance in pledging their support for giving consumers access to their healthcare information anytime, anywhere via third party apps—regardless of their provider or EHR vendor.
“We envision a future where any consumer can choose any application to retrieve both their complete health record and their complete coverage information from any provider or plan in the country,” the CARIN Alliance-HCTTF pledge states.
“As the CMS administrator pointed out in her speech, value-based care is part of the solution to the rising cost of healthcare. Yet, we cannot effectively transition to value-based care unless we give both a provider and a patient all clinical and coverage data at the point of care to inform decisions,” said HCTTF Executive Director Jeff Micklos.
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