CMS Needs to Expand its Scope of MACRA Interoperability Measures—Healthcare Experts
The American Hospital Association (AHA) and the American Medical Association (AMA), Healthcare Information and Management System Society (HIMSS), the Personal Connected Health Alliance (PCHA), and several other medical organizations are urging the government to reconsider how it measures interoperability. The organizations are responding to ONC’s request for comments on interoperability for the Medicare Access and CHIP Reauthorization Act (MACRA).
According to AMA President Steven Stack, “The lack of interoperability is one of the major reasons why the promise of electronic health records has not been fulfilled. Vendors have been incentivized to meet the flawed benchmarks under the Meaningful Use program. We need to replace those benchmarks with ones that focus on better coordinated care. MACRA offers that opportunity and we need to take advantage of it.” Stack urges CMS to focus on usefulness, timeliness, correctness and completeness of data, instead of using data exchange as the metric for measuring interoperability.
The HIMSS and the Personal Connected Health Alliance (PCHA) appeared to agree with many of the measure proposals presented by CMS. However, they think interoperability measurement needs to be more robust.
In a letter HIMSS president and CEO H. Stephen Lieber, CAE, and vice president Dana Alexander, RN, MSN, MBA, FAAN, FHIMSS, proposed “We observed that the patient perspective, and their ability to access their health information, is missed in this definition and should be considered in any metrics that assess interoperability. In our healthcare system’s continued shift to a value-based payment system, patients and the care they receive should be at the forefront and fully considered in assessing overall interoperability and health information exchange.”
Lieber and Alexander also proposed that the healthcare community would benefit from ONC examining the extent to which clinicians make decisions by incorporating exchanged data. According to them, “The resulting analysis and guidance could have a greater impact on care delivery than simply looking at the technical capabilities between interoperable systems.”
Additionally, HIMSS and PHCA also suggested measuring the metrics, such as—sending e-prescriptions, incoming lab results, incoming imaging results, sending to immunization registries, sending reportable labs to public health, and sending syndromic surveillance data to public health.
In a letter to ONC, the American Academy of Family Physicians (AAFP) recommended interoperability measures that are patient-centric to advance care coordination and continuity. They said “Interoperability is a complex task for which a few guiding principles should be adopted, recommending the following: measures should not add administrative burden to clinicians or their practices, and multiple data sources should be utilized to measure interoperability.”
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