Meaningful Use

The President and CEO of HIMSS highlights some of the major announcements and activities at HIMSS16, including new government funding for health IT and the expanding global involvement at the conference.

Arguing that too many well-meaning providers are facing financial penalties from meaningful use, the American Hospital Association called on the Centers for Medicare and Medicaid Services this week to offer more flexibility. Specifically, AHA says hospitals that meet 70 percent of meaningful use requirements should be deemed as having complied with the program. With the current "all-or-nothing approach," writes Ashley Thompson, AHA's senior vice president of public policy analysis and development, "failure to meet any one of the requirements under the Medicare and Medicaid EHR Incentive Programs has meant a provider would not receive an incentive payment; more recently, it has meant a provider would be penalized." [Also: Hospitals press HHS on meaningful use] Given the huge complexity and high hurdles of meaningful use, the fact that a hospital missing a given threshold by small amount leads to overall failure is "unfair to providers that make good faith efforts to comply," according the March 22 letter to CMS Acting Principal Deputy Administrator Patrick Conway, MD. CMS has told AHA that it doesn't have the statutory authority to offer anything less than that absolutist approach, according to the letter. But AHA offers a legal analysis that suggests that's not true: "We believe that CMS possesses the authority to eliminate the all-or-nothing approach to meaningful use and that the agency should do so." Among the arguments put forth by CMS for the necessity of an all-in requirement: The law requires more stringent MU measures to improve quality over time; certain measures capture policies, such as health information exchange, that are specifically required by statute; use of a "qualified EHR" must meet all the requirements, not some, in order to meet the law's objectives. The agency has also argued that a more flexible framework wouldn't reduce providers' reporting burden anyway – a contention with which AHA "respectfully disagrees" but points out isn't statutorily binding anyway. "We strongly believe that CMS is not legally required to maintain its  all-or-nothing approach to meaningful use," AHA argues, but instead has "ample legal authority" to adopt a more forgiving approach like the 70 percent threshold it suggests. "This flexibility would support providers who have implemented IT functionality but may not have optimized each function sufficiently to meet the full set of requirements in the EHR Incentive Program in order to avoid a payment adjustment." Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

More than 30 healthcare provider organizations have banded together to urge the Centers for Medicare and Medicaid Services to adopt a 90-day reporting period for meaningful use measures in 2016, rather than full-year reporting as CMS has proposed. Providers proved successful when they rallied for 90-day reporting for 2015. [Also: Meaningful use will still be part of MIPS reimbursement] In a March 15 letter to CMS Acting Administrator Andy Slavitt, the groups said the changes CMS made in the Modified Stage 2 final rule for 2015 provided welcomed relief to the provider community. As they see it, full-year reporting in 2016 would demand complex system changes: "For many providers, these system changes will impact their ability to comply with the full-year reporting period," they wrote. CHIME, which represents more than 1,800 healthcare chief information officers, is leading the call for 90-day reporting. [Also: Healthcare industry cheers meaningful use modifications] "Healthcare providers are firmly committed to using information technology to transform the delivery system," CHIME Board Chair Marc Probst, CIO at Intermountain Healthcare, and CHIME President and CEO Russell Branzell, said in a joint statement. "Changes made to the meaningful use program last year provided welcomed relief from burdensome regulatory requirements.” "Providers now are awaiting further changes to the program spurred by the Medicare Access and CHIP Reauthorization Act of 2015. However, the current regulatory scheme still calls for a 365-day reporting period. Until the final MACRA rules are issued, providers will be greatly challenged to meet the reporting requirements,” they said. [Like Healthcare IT News on Facebook] "Maintaining 365-day reporting period also will force providers to pull resources away from using health IT to innovate care processes and workflows. Additionally, it will limit the amount of time providers and vendors could spend on improving interoperability and information exchange." Organizations supporting the change are: American Academy of Dermatology Association American Academy of Family Physicians American Academy of Neurology American Academy of Ophthalmology American Association of Clinical Endocrinologists American Association of Neurological Surgeons American Association of Orthopaedic Surgeons American College of Cardiology American College of Mohs Surgery American College of Physicians American College of Rheumatology American College of Surgeons American Gastroenterological Association American Society for Dermatologic Surgery American Society for Gastrointestinal Endoscopy American Society of Nuclear Cardiology American Society of Plastic Surgeons American Urological Association America’s Essential Hospitals Association of Medical Directors of Information Systems Cardiology Advocacy Alliance Coalition of State Rheumatology Organizations College of Healthcare Information Management Executives Congress of Neurological Surgeons Federation of American Hospitals Heart Rhythm Society Infectious Diseases Society of America Medical Group Management Association National Association of Spine Specialists National Rural Health Association Oncology Nursing Society Premier healthcare alliance Society for Cardiovascular Angiography and Interventions United Surgical Partners International Twitter: @Bernie_HITN

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Meaningful use: was it meaningful, useful, neither or both? HIMSS Social Media Ambassadors lock horns on the hotly contested program which is set to be gradually phased out. Hosted by Beth Jones Sanborn, Managing Editor of Healthcare Finance News.

Value-based program will score physicians on quality, resource use, practice improvement and certified technology.

As policy wonks and advocates battle over just how much meaningful use will likely change in 2016, the Physician Quality Reporting System might have snuck up on healthcare IT staffs tasked with implementing new technology platforms. "The focus for most of the health IT folks has obviously been meaningful use regulations, and there hasn’t been a lot of focus on the PQRS," said Deborah Gash, CIO of Kansas City, Missouri-based St. Luke's Health System. In fact, Gash said she actually had what she called an "aha!" moment when colleagues at St. Luke's began asking her about how best to address PQRS stipulations in concert with other reporting requirements. [Also: 21 awesome photos from past HIMSS conferences] Gash and Anantachai Panjamapirom, senior consultant at The Advisory Board Company, will present on St. Luke's experience in "PQRS and Alignment Opportunity — Concept to Operationalization," during HIMSS16 beginning in late February. "Bringing awareness to what this program is, how we were able to work through all the operational issues, and create a program to allow us to follow through and successfully meet the requirements was something we thought would be worthwhile to share," Gash said. Panjamapirom said numerous Advisory Board clients, such as St. Luke's, have already taken steps to align not only MU and PQRS, but also try to devise strategies to bring other programs, such as Hospital Inpatient Quality Reporting and the Value-Based Payment Modifier, into efficient alignment. Twitter: @HealthITNews "Most of what you have to do is workflow and culture changes," Gash said, "such as documenting the right elements and being consistent about it, plus developing workflows and decision support tools in your EHR to ensure you're getting the quality data captured. That's really where the lion's share of the work is for organizations." Gash also said larger organizations are not necessarily better prepared to operationalize alignment. "I think the complexity of the organization can increase your risk," she said. "I find smaller practices that are paying attention do quite well.  It's that lack of awareness and understanding of what you have to do in the requirements that puts you at risk." "PQRS and Alignment Opportunity - Concept to Operationalization" will be presented March 1 from 2:30 - 3:30 p.m. at Sands Expo Convention Center, Palazzo D. Twitter: @HealthITNews This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

Have you heard of the #HIMSS16 MixTape? Well, Colin Hung is the man who put that together. He also founded and moderates the Healthcare Leadership (#hlcdr) and serves as a healthcare marketing executive at Stericycle Communications Solutions in Toronto. And at HIMSS16 he’ll be among the Social Media Ambassadors credentialed to cover the conference via multiple channels. See all of our HIMSS16 previews Hung answered our questions leading up to HIMSS16. Q: What’s your top health IT prediction for 2016? A: There will still be more talk about interoperability in 2016 than action. On a more optimistic side, I think that the conversation will shift from compliance to innovation in 2016.  Q: What are you most looking forward to learning about at HIMSS16. A: I'm really excited about the latest developments in Artificial Intelligence for healthcare. I think IBM Watson and other related technologies have the potential to revolutionize the way healthcare is delivered. I'm definitely hoping to learn more about the practical applications for that Big Data + AI combination. I'm also looking forward to seeing what's next for the EHR vendors. Now that the meaningful use program is in its twilight, I'm really curious to see if one of the players decides it's time to "break-the-mold" and take their system in a completely new direction. I certainly hope someone will seize this opportunity once the meaningful use shackles come off.  Q: What inspired you to apply for the SMA program? A: Since the program started, I've made it a point to follow the SMAs during HIMSS and I have always found their tweets, posts and comments to be extremely valuable. At a conference the size of HIMSS there is a lot of noise. I find that the SMAs help cut through the babble and they somehow find a way to highlight undercurrents that might have otherwise gone unnoticed. It's exciting to be part of the SMA team doing that at #HIMSS16. Q: What in your mind are the untold benefits of social media in healthcare today? A: I think one of the most untapped uses of social media in healthcare is crowdsourcing feedback. Twitter, Facebook and LinkedIn are amazing platforms to test ideas. There isn't another place where you can go and tap into a community of people who are passionate about improving healthcare for feedback. I'm constantly pinging friends I've met online for their opinion on ideas that I have, to clarify my understanding of a particular topic or to ask for reference materials. If I were involved in product development I'd tap into social media to solicit feedback on UX/UI designs and vet approaches to developing products. That to me is the one of the greatest uses of social media that very few are realizing.  Q: What's something that even your devout followers likely don't know about you? A: Oh this is a tough one. I think most people know about my love of all things SciFi and how I first met John Lynn (@techguy) while tweeting/texting using a phone in each hand at HIMSS12. But what people probably don't know is that I love sushi. Can't get enough of it.  Twitter: @SullyHIT This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

IT veteran Laura Young will share best practices for health information exchange among long-term post-acute care and mental and behavioral health providers  at HIMSS16.

While rural providers have adopted health IT at the same time or at greater rates as their urban counterparts, meaningful use varies dramatically among them, according to a recent HealthAffairs study.