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Health data exchange needs new policy push, say ONC and CMS

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Health data standards development and existing federal incentives for electronic health record adoption won't bring about the widespread electronic sharing of individual medical data among care providers, say the federal organizations charged with administering those incentive programs and developing health information technology standards.

As a result, new levers made possible by the 2010 healthcare reform law such as changes to payment policy or to regulatory requirements for acceptable quality in healthcare entities could be necessary, say the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health Information Technology.

In a request for information issued (.pdf) March 6, CMS and ONC say neither providers nor vendors "have a business imperative to share person level health information across providers and settings of care." That amounts to a significant barrier to achieving a new era of coordinated, patient-centric healthcare, the RFI also says.

Although interoperability is a part of the stage 2 meaningful use requirements established by the EHR adoption incentive program and will likely be part of stage 3, EHR uptake among institutions such as long-term acute care hospitals, rehabilitation and psychiatric hospitals are in the single digits, the RFI says.

But, nearly a third of Medicare beneficiaries discharged from acute care hospitals--institutions covered by the EHR adoption incentive program--go to a post-acute care setting, the RFI notes.

In the RFI, CMS says it could drive medical data sharing through measures such as modifying clinical standards embedded in Medicare health and safety standards--which besides covering hospitals, also cover nursing homes, home health agencies and hospices--so they require electronic exchange of health information.

The organizations ask for feedback, such as "what changes in payment policy would have the most impact" and "to what extent do current CMS payment polices encourage or impede" health data exchange across providers, particularly market competitors.

For more:
- download the RFI (.pdf)

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