AMIA Public Policy and Government Relations Update Margo Edmunds, Chairperson, AMIA PPC Doug Peddicord, President, Washington Health Strategies Group Meryl Bloomrosen, Vice President, Public Policy AMIA March, 2012 www.amia.org
Today's Discussion Topics • Welcome and Presenter Introductions- Margo • Purpose of Today’s Webinar- Margo • AMIA’s Policy Goals and Objectives • AMIA’s 2011-2012 Policy Priorities • AMIA’s Ongoing Policy Activities • Legislative and Capitol Hill Happenings- Doug • Other Relevant Policy Activities- Meryl www.amia.org
AMIA’s Public Policy Goals and Objectives • Represent AMIA and build valuable relationships in Congress and the Administration • Educate Congress and the Administration about issues important to AMIA and its members • Present AMIA as a resource to members of Congress and the Administration • Spread awareness about AMIA, health information technology and informatics • Provide objective input into the public policy discourse and help inform public policymakers • Educate members about relevant issues in public policy www.amia.org
2011-2012 Public Policy Priority Topics Informatics Research and Funding – AHRQ – NIH – NLM – NINR Impact of health IT on Patient Safety and Quality of Care – Meaningful Use (defending MU incentives) – Ensuring safe, effective use of health IT and EHRs Informatics and health IT Workforce (includes education and training) – Informatics competencies – Funding for training programs; pipeline of trainees EHR Best Practices, Lessons Learned and Successes – EHR Evaluation – EHR Usability – Evolution of Clinical Decision Support www.amia.org
Ongoing Public Policy Related Activities • Compile and Submit Official AMIA • Monitor and Track Congressional Comments Activities • Conduct Agency Visits • Provide Testimony • Conduct Congressional Visits • Represent AMIA at Meetings and Hearings • Conduct Policy Sessions at AMIA Educational Meetings • Submit Nominations for Committees and Task Forces • Conduct Policy Updates • Track Legislation and Regulations • Convene Invitational Policy of Interest to Members and the Meetings and Develop Informatics Community Proceedings (since 2006) • Track Federal Agency Activities • Host AMIA Hill Day www.amia.org
Legislative and Administrative Happenings www.amia.org
President’s FY 2013 Budget Proposal ( In millions) AHRQ: • 2012: $405 • 2013: $409 CDC: • 2012: $5,732 • 2013: $5,068 NIH: • 2012: $30,702 • 2013:$30,702 (no change from 2012) www.amia.org
President’s FY 2013 Budget Proposal • Of the funding levels proposed for the Centers of NIH, NLM was the recipient of one of the greatest increases. • National Library of Medicine’s proposed funding level is set to increase from $338 million to $373 million – 10.4% • ONC is set to receive $66 million, an increase of $5 million above FY12. www.amia.org
Hot Topics in HIT • Meaningful Use • Breach reporting – BCBS of Tenn. to pay $1.5 million • HIPAA enforcement by state Attorneys General • HIPAA enforcement on BAs • Administration's Privacy Bill of Rights • “The learning healthcare system” • “Big Data" in health care www.amia.org
Meaningful Use Stage 2- EPs Stage 2 MU Objectives and Measures for EPs Objective Measure Notes, Comments, Queries CORE SET (EP must meet all 17 Core Set objectives) Exclusion: Any EP who writes fewer than 100 medication, laboratory, and radiology orders during the EHR reporting period. Measure in Stage 1 was 30 percent. EP must personally use the CPOE function, verbally communicate the order to someone else who will use the CPOE function, or give an 1. Use CPOE for medication, laboratory, electronic or written order that must not be and radiology orders directly entered by More than 60 percent of retained in any way once the CPOE function any licensed healthcare professional who medication, laboratory, and has been utilized. CMS invites comment on can enter orders into the medical record radiology orders created by the whether CPOE order entry could be expanded per State, local, and professional EP during the EHR reporting to include non-licensed professionals, such as guidelines to create the first record of the period are recorded using CPOE. scribes. The proposed denominator is the order. number of medication, radiology, and laboratory orders created by the EP during the EHR reporting period. CMS encourages comments on whether a different denominator could be used – the HIT Policy Committee recommended a denominator of “patients with at least one type of order.” . www.amia.org
Meaningful Use State 2- Hospitals Stage 2 MU Objectives and Measures for Hospitals and CAHs Objective Measure Notes, Comments, Queries CORE SET (eligible hospitals/CAHs must meet all 16 Core set objectives) Exclusion: None. Measure in Stage 1 was 30 percent. Provider must personally use the CPOE function, verbally communicate the order to someone else who will use the CPOE function, or give an electronic or written order that must not be retained in any way once the CPOE function has been utilized. CMS invites comment on 1. Use CPOE for medication, laboratory, and More than 60 percent of medication, whether CPOE order entry could be radiology orders entered by any licensed laboratory, and radiology orders created expanded to include non-licensed healthcare professional who can enter by authorized providers of the hospital’s professionals, such as scribes. The orders into the medical record per State, inpatient or emergency department proposed denominator is the number of local, and professional guidelines to create during the EHR reporting period are medication, radiology, and laboratory the first record of the order. recorded using CPOE. orders created by providers in the hospital’s inpatient or emergency department during the EHR reporting period. CMS encourages comments on whether a different denominator could be used – the HIT Policy Committee recommended a denominator of “patients with at least one type of order.” www.amia.org
Permanent Certification Program Proposed Changes – Program Name Change • “ONC HIT Certification Program” – Revisions to EHR Module Certification Requirements Privacy and Security Certification Will not require upfront certification to P&S for the 2014 Edition CC • Policy outcome now reflected in Base EHR definition (which includes all P&S CC) – Other tweaks to make certification more efficient – Application of Certain New Criteria • § 170.314(g)(1): Automated numerator recording • § 170.314(g)(3): Non-percentage-based measures • § 170.314(g)(4): Safety-enhanced design www.amia.org
Meaningful Use Stage 2- Certification Criteria Redefining Certified EHR Technology Why ONC thinks it is important… 1.Provides greater flexibility 2.Clearer definition of CEHRT and its requirements 3. Promotes continued progress towards increased interoperability requirements 4. Reduces regulatory burden (EO 13563) www.amia.org
Other Upcoming Legislation and Regulations • HITECH Omnibus Final Rule: privacy revisions, security, enforcement, breach notification (not AOD) • NCVHS Report to Congress • De-identification • Data segmentation initiative • Comprehensive privacy and cybersecurity legislation- HIPAA carve-out language www.amia.org
Update on Health Reform Legislation and Potential Implications for AMIA • Potential for repeal of the ACA; Supreme Court to hear challenges on federalism and commerce clause grounds, (special attention focused on the Individual Mandate) on March 26-28. • IPAB a very hot issue, with Republicans and some Democrats looking to scuttle before it begins • Meanwhile, implementation goes on, and the HIT Standards and Policy Committees continue to weigh in on a broad range of topics, from MU to ACOs • Ongoing workforce and education/training issues • Comparative effectiveness research (CER) • Patient safety • Consumer engagement • Quality initiatives: bundled payments, medical home, ACOs; expand PQRI • Implementation of ICD10 www.amia.org
2012 Overview of Selected Activities • Patient Identity Coalition • ICD-10 Coalition • HR 3239: Safeguarding Access For Every Medicare Patient Act www.amia.org
HR 3239 - Safeguarding Access For Every Medicare Patient Act • Introduced by Rep. Tom Marino (R-PA) • Provides essential safe harbors for EHR users and vendors/software developers to the extent that they report problems to the Patient Safety Organizations. • Time limits on legal action and the “reckless disregard” standard for punitive damages. www.amia.org
Other Policy Related Initiatives and Projects • National Priorities Project (NPP) – Mike Shabot • ONC • HIT and Patient Safety Roundtable • Mobile Devices Roundtable • IOM • Best Practices Innovation Collaborative (team-based care) • Global Forum on Health Professional Education • Workshop: Informatics Needs and Challenges in Cancer Research • Workshop on Data Quality • Genetic Alliance: Genetic Testing and Data Management Summit www.amia.org
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