The Senate health committee on Tuesday approved wide-ranging legislation designed to improve healthcare information technology by modifying requirements relating to the development and use of electronic health records.
In a Feb. 9 executive mark-up session, the committee passed the Improving Health Information Technology Act (S. 2511) introduced by Sen. Lamar Alexander (R-Tenn.), chairman of the committee, and ranking member Sen. Patty Murray (D-Wash.), which was also co-sponsored by Sens. Michael Bennet (D-Colo.), Bill Cassidy, M.D. (R-La.), Orrin Hatch (R-Utah) and Sheldon Whitehouse (D-R.I.).
By a roll call vote of 22-0, senators unanimously approved the legislation—a companion bill to the 21st Century Cures Act that was passed by the House of Representatives last year.
Alexander told the committee that health IT is critical to enabling national healthcare priorities such as the industry’s transition from fee-for-service to value-based payment models and the Obama administration’s $215 million Precision Medicine Initiative, which “absolutely depend on the success of electronic medical records.” However, he said EHRs are currently “in a ditch” and that the Improving Health Information Technology Act is among the “most important work that this committee has done.”
Sen. Lamar Alexander (R-Tenn.) The EHR problems that the bill seeks to address include unnecessarily burdensome physician documentation requirements, a lack of HIT interoperability and poor usability, as well as information blocking by both providers and vendors. In particular, it would establish a star-rating system for EHRs based on security, usability and interoperability to help providers better choose health IT products.
According to the legislation, the Office of the National Coordinator for Health IT will publish the criteria and methodology used to determine the star ratings on its website. Further, the Secretary of Health and Human Services is given authority to decertify vendors’ HIT products if they do not improve from a one-star performance rating.
In addition, the bill gives the HHS Office of the Inspector General authority to investigate and establish deterrents to information blocking practices that interfere with appropriate sharing of electronic health information.
“The Improving Health IT Act would make it easier for providers to vote with their feet when it comes to electronic health record systems and end the unfair practice of information blocking,” said Murray. “It will offer new tools to help move the market for health IT towards more usable products that can easily share information when a provider needs it and encourage better patient access to their own health records so they can be more empowered to make informed healthcare decisions with their doctors.”
The legislation directs the HHS Secretary, in consultation with ONC, to promote policies that ensure that a patient’s electronic health information is accessible to that patient—and their designees—in a manner that “facilitates communication with the patient’s healthcare providers and such patient’s choices, including with respect to research.”
Murray added that America’s health IT infrastructure is an area where there is “a lot of momentum and a lot of opportunity to make progress for patients.” She argued that EHRs can make “an incredible, even life-saving difference in patient treatment and health” but it requires the advancement of legislation to “make sure our health IT system works better for patients and providers.”
“My medical health information is mine. That’s the law but most Americans don’t really understand that and have a difficult time getting access to their own information,” commented Alexander.
To increase awareness of patients’ rights to access their health records under HIPAA, the legislation calls on the HHS Office for Civil Rights—in consultation with ONC—to help consumers and providers better understand patient rights, including “providing best practices for requesting personal health information in a computable format” such as using patient portals or third-party applications.
The bill also orders ONC—in coordination with OCR—to use existing authorities to encourage health information exchange organizations and networks to partner with providers, health plans, and other appropriate entities to offer patients access to their electronic health information in a “single, longitudinal format that is easy to understand, secure, and may update such information automatically.”
Nonetheless, Whitehouse said that while “this is a great piece of legislation, there’s a lot more that still needs to be done” in the area of health IT.
“We need to provide a lot more support to the health information exchanges, rather than just continuing with Meaningful Use,” he concluded. “We’ve got to address privacy issues that are bedeviling these systems…which were written before there were electronic health records and need to be adjusted. And, finally we need to do something for behavioral health and for nursing homes who are outside of the Meaningful Use parameters.”
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