By David Pittman | 04/19/2017 10:00 AM EDT
WHAT WASN'T RECENTLY ANNOUNCED BY CMS: Hospitals claimed victory late last week when CMS announced a 90-day meaningful use reporting period next year as part of its first major payment rule issued in the Tom Price era. But a bigger story (which Morning eHealth is noticing after the dust settled) is that HHS didn't delay the required use of 2015 certified EHRs - although most of the health IT community had been pushing for that delay.
- The eagle-eyed Mari Savickis, CHIME regulatory policy guru, pointed to page 1,390 of the rule, which states that CMS predicts 85 percent of hospitals and 75 percent of doctors will have 2015 certified products by the start of next year, when providers are currently mandated to start using them. Those predictions are based on the experience of the move to 2014 certified products. Those numbers weren't enough to get CMS to slow down the 2015 certification timeline. In contrast, the readiness promoted CMS to go with a 90-day reporting period for meaningful use, the agency said.
The key point comes on page 1,403 of Friday's rule, where CMS says it'll work with ONC to monitor the status of 2015 certified EHRs. "If we identify a change in the current trends and significant issues with the certification and deployment of the 2015 Edition, we will consider flexibility in 2018," the rule states. Options include allowing providers to use either 2014 or 2015 technology next year, or a combination of the two. The agency is, however, inviting comment on the issue.
- "The current 2018 timeframe CMS is sticking to is cutting it too close," Savickis complained. No doubt that providers will continue to push hard for a delay. The silver lining for them is that CMS will be issuing additional Medicare payment rules in the coming weeks and months, providing additional opportunities for it to budge on this issue. The 2018 physician fee schedule is under White House view as of this week.
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COMING TODAY: EHR TRAINING INITIATIVE: The American Medical Association will announce an effort this morning to make sure medical students and residents have better training on how to use EHRs, according to a press advisory issued Tuesday. "The focus is on a new way we're making sure future docs have access to, understand the capabilities of, and use EHRs during med school as opposed to getting up to speed while already in practice... which is the norm for the majority of the physicians graduating from med school today," an AMA spokesman told us.
- The call starts at 10:30 a.m. on the east coast and features representatives from the UConn School of Medicine and Regenstrief Institute.
Doctor groups have been pushing for better EHR training for med students for some time. The AMA in 2013 funded efforts to help medical schools develop curriculum on EHR use. The American Osteopathic Association in 2014 amended policy to promote EHR training in med school. The Association of American Medical Colleges also in 2014 encouraged academic medical centers to allow student access to EHRs.
TOM PRICE'S REPLACEMENT STILL UNKNOWN: The race for Price's old congressional seat is headed to a June 20 runoff. Democrat Jon Ossoff won about 48 percent of the vote, short of the 50 percent needed to avoid a runoff in the heavily GOP Georgia district. Former Secretary of State Karen Handel was the top Republican vote-getter.
TEXAS BILL TAKES ANOTHER STEP: The Texas House Public Health Committee on Tuesday gave the OK to the telemedicine bill that will end the standoff between the Texas Medical Board the Teladoc. The bill, in contrast to the companion unanimously passed in the state Senate late last month, cleans up language in the section that requires health insurers pay for telemedicine visits, making clearer plans didn't have to pay for faxes, texts and phone calls. Health plans in the Lone Star state previously expressed concern over the section. State Sen. Charles Schwertner's office, the doctor who backed the bill in the upper chamber, tells us that the compromised language is agreed upon by both chambers, the Texas Medical Association, the Texas Hospital Association, the Texas Association of Health Plans and several others.
EHRs TAKE UP LOTS OF TIME EVERYWHERE: We hear complaints pretty routinely that doctors' work-EHR-life balance is not-so-great, often with the argument that it's just an American thing. A new study, published in the Annals of Internal Medicine, suggests that the phenomenon is international: after examining 66 Swiss residents in Lausanne - using a Cerner EHR - researchers found that more than half the residents' time was spent interacting with the EHR, with a very small proportion actually interacting with patients.
It's possible, however, that the time spent with EHRs is merely taking the place of other older tasks, as the researchers cite studies conducted in the 90s with similar low proportions of direct-patient-interaction time. Nevertheless, they conclude that organizations and their EHRs must improve to give clinicians their face time back.
MEDICARE CRACKS THE WHIP ON HOSPITAL ACCREDITORS: CMS is taking steps to require private hospital accreditors like the Joint Commission to make public problems they discover during inspections, Pro Publica's Charlie Ornstein scoops. The issue bubbled up when CMS noticed hospital accreditors missed deficiencies later found by state inspectors. State officials examined 103 acute-care hospitals in 2014 that were inspected by an accreditor in the last 60 days. "The state officials found 41 serious deficiencies. Of those, 39 were missed by the accrediting organizations," Charlie writes.
The disparity "raises serious concerns regarding the [accrediting organizations'] ability to appropriately identify and cite health and safety deficiencies" during inspections, CMS officials wrote in Friday's proposed hospital payment rule. More from Charlie here.
WHEN YOU THOUGHT THE THERANOS CONTROVERSY WAS SETTLED: A day after Theranos settled its dispute with CMS, Arizona announced the embattled lab testing company will be banned from the state for two years and refund the state's customers. With roughly 1.5 million blood tests and more than 175,000 Arizonans as customers, the refunds will total $4.6 million, Attorney General Mark Brnovich said in a release . "This is a great result and a clear message that Arizona's consumer protection laws will be vigorously enforced," Brnovich said.
WHAT WE'RE CLICKING:
Nurse lays out the importance of using OpenNotes.
The head of the Federation of American Hospitals says we have a "Balkanized quality measurement and reporting process."
Attorneys break down the new telemedicine rule in Ohio.
JAMA Viewpoint access the changes in the recent Common Rule.
Former Microsoft executive Steve Ballmer is creating USAFacts, a fully integrated look at revenue and spending across federal, state and local governments.
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