HIT Policy Committee’s “Letters of Transmittal” Recommendations to National Coordinator for Health IT
from August and July 2009 Meetings
Policy Transmittal Letters site
“The HIT Policy Committee, a federal advisory committee, provides recommendations on HIT policy issues to the National Coordinator for his consideration. The National Coordinator is also the Chair of the HIT Policy Committee, and, therefore, a formal transmittal letter must transmit the recommendations from the Policy Committee to the National Coordinator in his role as an HHS official. Once the FACA has been satisfied (i.e., a transmittal letter sent from the Committee to the National Coordinator in his governmental role), the National Coordinator can then determine the disposition of the recommendations.”
August 14, 2009 Policy Committee Meeting Transmittal Letter
PDF version HTML Excerpted from ONC site pasted below:
David Blumenthal, MD, MPP
National Coordinator for Health Information Technology
Department of Health and Human Services
Washington, DC
Dear Dr. Blumenthal:
The HIT Policy Committee (the Committee) is charged with recommending to the National Coordinator a policy framework for developing and adopting a nationwide health information technology infrastructure for the electronic exchange and use of health information technology. Therefore, the Committee is submitting to you recommendations that we finalized at our August 14, 2009, Committee meeting. At that meeting, the Committee heard presentations and received advice on a variety of topics from two of its Workgroups, the Certification/Adoption Workgroup and the Information Exchange Workgroup. After considerable discussion of those presentations and the Workgroups’ input, the Committee agreed upon several recommendations, as described below.
The Certification/Adoption Workgroup’s presentation pertained to certification criteria for electronic health records (EHRs) which are specified in the American Recovery & Reinvestment Act (ARRA) of 2009, and certain EHR functional requirements that support Meaningful Use objectives.
As background, ARRA authorized the Centers for Medicare & Medicaid Services (CMS) to provide a reimbursement incentive for eligible professionals and hospital providers who are “meaningful users” of certified electronic health records (EHRs). This incentive payment is anticipated to begin in 2011 and gradually decrease through 2014, after which providers are expected to have adopted and be actively utilizing an EHR in compliance with the “meaningful use” definition or they will be subject to financial penalties.
The Committee discussed the Workgroup’s advice and reached several important decisions regarding a certification process, expansion of the process to improve its objectivity and transparency, and a proposed short-term certification transition plan. Based in part on the Workgroup’s input, the Committee is submitting to you for your consideration the following.
RECOMMENDATIONS
We recommend that in defining the certification process for an electronic health record (EHR), the following objectives are pursued:
1. Focus certification on Meaningful Use.
2. Leverage the certification process to improve progress on privacy, security, and interoperability.
3. Improve the objectivity and transparency of the certification process.
4. Expand certification to include a range of software sources, e.g., open source, self-developed, etc.
5. Develop a short-term certification transition plan.
The second set of recommendations originated from the Committee’s Information Exchange Workgroup. During the August 14th meeting, the Committee considered the Workgroup’s input, which focuses on those Meaningful Use objectives that require health information exchange. After lengthy discussion, the Committee decided on the following four high-level recommendations as they relate to health information exchange, and are submitting them to you.
RECOMMENDATIONS
1. Information exchange requirements: The core information exchange requirements must be technology- and architecture-neutral, and apply to all participants seeking to demonstrate meaningful use to the Centers for Medicare & Medicaid Services (CMS).
2. Core requirements: Consistent with the recommendations of the Certification/Adoption Workgroup, these core requirements should be focused on the capability to achieve meaningful use and include interoperability, privacy, and security.
3. Certification of interoperability components: The federal government should certify EHR and health information exchange components on these core requirements to ease the burden on eligible professionals and hospitals for meeting and demonstrating adherence with meaningful use requirements.
4. Aligning federal and state efforts and bringing existing efforts into alignment: Federal and state-government approaches should be complementary, and grants to states should require alignment with federal meaningful use objectives and measures.
The Committee recommends that the National Coordinator accept (1) its Recommendations on certification and the certification process, and (2) its Recommendations focusing on those Meaningful Use objectives that require health information exchange. Further, the Committee requests that the National Coordinator recommend to the Secretary that the appropriate operating and staff divisions (OP/STAFFDIVs) within the Department be directed to consider how best to address and/or implement the Recommendations.
We fully appreciate your Office’s and the Department’s leadership role and efforts to advance widespread adoption of interoperable health information technology in the United States.
Sincerely,
Paul Tang
Vice Chair Health IT Policy Committee
July 16, 2009 Policy Committee Meeting Transmittal Letter
PDF version HTML Excerpted from ONC site pasted below:
August 10, 2009
David Blumenthal, MD, MPP
National Coordinator for Health Information Technology
Department of Health and Human Services
Washington, DC
Dear Dr. Blumenthal:
The Health IT Policy Committee (the Committee) received a number of recommendations from its Workgroups during the July 16, 2009, Committee meeting. The first recommendation, which came from the Meaningful Use Workgroup, pertains to the definition of “meaningful use,” and focuses on improved health outcomes and efficiency as demonstrated through the meaningful use of certified electronic health record (EHR) technologies. During that meeting, the Committee considered the recommendation and decided to adopt it as its own.
As background, the American Recovery and Reinvestment Act of 2009 authorized the Centers for Medicare & Medicaid Services (CMS) to provide a reimbursement incentive for eligible professionals and hospitals who are “meaningful users” of certified electronic health records (EHRs). This incentive payment is anticipated to begin in 2011 and gradually decrease through 2014, after which providers are expected to have adopted and be actively utilizing an EHR in compliance with the “meaningful use” definition or they will be subject to financial penalties.
As we understand, CMS intends to publish a proposed rule in the next 12 months to propose a definition of meaningful use of certified Electronic Health Records (EHR) technology and establish criteria for the incentives programs. We have been informed that CMS is working with the Office of the National Coordinator (ONC) to identify the proposed criteria. Consequently, the work of the HIT Policy Committee serves an advisory purpose, and will hopefully lay a foundation for the policies, which as we understand, will be proposed by the Secretary and subject to public comment.
The ultimate goal of meaningful use of an EHR is effective use and exchange of electronic health information to improve health care and manage chronic disease while decreasing costs and inefficiencies. However, this will be a gradual process that will require time, education, workflow redesign, and seeks to improve the delivery of medical care. In order to achieve widespread use of health information technology, it is important to start with a basic set of features and capabilities focusing on data collection and build on these capabilities that can become the basis for improved performance in subsequent years.
The Committee reached several important decisions regarding the definition of meaningful use, progressing from a focus on process to achieving measurable outcomes that support patient engagement and improved care coordination. Five health outcomes are prioritized for consideration by the National Coordinator and ultimately for the Department of Health and Human Services (HHS): improve quality, safety, efficiency, and reduce health disparities; engage patients and families; improve care coordination; improve population and public health; and ensure adequate privacy and security protections for personal health information.
RECOMMENDATION
We are submitting to you as our Recommendations the attached matrix for your consideration and possible consideration by the Department of Health and Human Services (HHS) in defining “meaningful use” of an electronic health record (EHR).
The second set of recommendations originated from the Committee’s Certification/Adoption Workgroup. During the July 16th meeting, the Committee considered the recommendations, which focus on improving the certification process to ensure that a system is able to achieve government requirements for security, privacy, and interoperability, and that the system would enable the Meaningful Use results that the government expects.
After lengthy discussion, the Committee accepted the following high-level recommendations as they relate to certification and are submitting them to you as our recommendations.
RECOMMENDATIONS
1. Focus certification on meaningful use.
2. Leverage the certification process to improve progress on security, privacy, and interoperability.
3. Improve the objectivity and transparency of the certification process.
4. Expand certification to include a range of software sources: open source, self-developed, etc.
5. Develop a short-term transition plan for the certification process.
The Committee recommends that the National Coordinator accept its Recommendation on “meaningful use,” and its Recommendations on Certification, and further request that the Secretary direct the appropriate operating and staff divisions (OP/STAFFDIVs) within the Department to consider how best to address the Recommendations.
We fully appreciate your Office’s and the Department’s leadership role and efforts to advance widespread adoption of interoperable health information technology in the United States.
Sincerely,
Paul Tang
Vice Chair Health IT Policy Committee
Attachment: Matrix on Meaningful Use Objectives and Measures (pdf)
See HIT Standards Committee’s Formal Recommendations on e-Healthcare Marketing.
