In a letter to Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner, Matt Murray, MD, specified several concerns TMA has with the agency's proposed modifications to the 2014 Medicare and Medicaid electronic health record (EHR) incentive programs.
In the letter, the chair of the TMA Ad Hoc Committee on Health Information Technology requests emergency suspension of the certified EHR requirement that physicians use a certified patient portal and the Stage 2 meaningful use requirement that 5 percent of patients view, download, or transmit their information using the patient portal.
"Instead, for 2014 it should be adequate that the physician provides an electronic copy of the Consolidated Clinical Document Architecture (C-CDA) summary that the patient can upload to a portal of his or her choice," TMA recommends, adding that "failure to do this will result in portal silos that will be detrimental to patient satisfaction and care."
In addition to the patient portal requirement, TMA's letter identifies health information exchanges (HIEs) as a "factor causing physician non-participation in meaningful use Stage 2." The association says HIEs are maturing but have yet to connect many physicians. "Physicians are concerned about being held liable for HIPAA violations outside of their control after submitting protected health information (PHI) to the local HIE," Dr. Murray writes.
Questions TMA would like CMS to answer include:
- Has CMS conducted patient studies to see whether a majority are interested in accessing their patient portal?
- Has CMS conducted studies to determine improved outcomes based on patient access to health information?
- Has CMS studied the impact of creating separate silos of patient information versus having a single consolidated personal health record?
"While TMA agrees that patient engagement and accountability are good for health care, the requirement for meaningful use needs significant revision," the letter states.
Action, Aug. 1, 2014