Medicare chief wants health record vendors to ease access

Federal law puts health IT vendors on the hook to improve interoperability of health records. Now that implementation is drawing near, the government's biggest health care payer is getting serious about making sure companies are paying attention. A recent law is  improving access to electronic health records.

Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services, had tough talk on the subject at the annual meeting of the American Medical Association.

"It's…time to ask a lot more of the technology and technology vendors," he said.

The Medicare Access and CHIP Reauthorization Act, dubbed MARCA, takes effect in January 2017. Broadly speaking, the bill combines three separate programs -- the Physician Quality Reporting System, the Value Modifier, and the Meaningful Use program covering electronic health records -- with one patient-centric Quality Payment Program designed to reward physicians that provide quality health care. The bill is designed to reduce duplicative reporting requirements for medical practices.

When it comes to technology, Slavitt said, "physicians are frustrated." CMS, he said, is hearing from practitioners that "measures become exercise in compliance, instead of quality improvement," and that "technology has often distracted instead of supported patient care."

Slavitt said the time has come to put "more pressure on technology vendors and less burden on physicians, so physicians can do simple things like track referrals when a patient sees another specialist or visits a hospital." Slavitt noted that, "as in the rest of our lives, the burden needs to be on the technology, not the user. [Electronic health record] vendors and hospitals that use them will now be required to open their APIs so data can move in and out of an application safely and securely. This will also serve to help eliminate the 'desktop lock' that occurred based on early EHR decisions by allowing technology to more easily plug and play. Today’s data silos are more a function of business practices than technology capability and we cannot tolerate it any longer."

Slavitt said he envisioned MARCA implementation as path to "reversing a pattern of regulations and frustration, and ultimately unleashing a new wave of collaboration between the people who spend their lives taking care of us and those of us whose job it is to support that cause."

At its core, Slavitt said, the plan centers on four primary themes: being patient-centric; being flexible to support the needs of patients and clinicians; focusing on concerns specific to small practices; and maximizing doctors’ time spent with patients.

Despite promises for increased simplicity, Slavitt made clear that the new proposal "will hit bumps as new policies run into the realities of every day medicine" and as clinicians adapt to the new model. To ease the implementation of the technological aspects of MACRA, CMS plans to provide explanatory webinars, in-person meetings, fact sheets and web portals for clinicians nationwide.

Final comments on the plan are due June 27, and Slavitt urged physicians to provide feedback on how to further simplify the plan, and make the burden of doctors and patients as light as possible.