But several organizations representing sectors of the health care industry have pronounced the bill as unworkable. These groups cite provisions that actually would hinder I.T. adoption. “There’s no medical association that remotely supports this,” says Justin Barnes, vice president of government affairs for Greenway Medical Technology Inc., a Carrollton, Ga.-based vendor of physician software. He’s also chair of the HIMSS Electronic Health Records Vendors Association, a subset of the Chicago-based Healthcare Information and Management Systems Society.
In late July, the House Energy and Commerce Committee passed the legislation, H.R. 6357, which is known as the Protecting Records, Optimizing Treatment and Easing Communication through Healthcare Technology Act. The House Ways and Means Committee is expected to consider the bill following the congressional summer break.
A major concern of the bill revolves around its proposed changes to patient consent procedures. Under current law, patients must give informed consent for their identifiable electronic information to be used for marketing and other purposes beyond treatment, payment and health care operations.
But the legislation approved by the Energy and Commerce Committee requires patient consent for any use of their identifiable electronic information during any part of the health care process. This means a physician sending information to another physician, or provider or payer organizations analyzing data to measure care delivery, must get consent every time a patient’s data is used.
“A new addition to the bill would require providers--on a claim-by-claim basis--to tell the health plan whether the provider has the patient’s consent to use the patient’s information for quality or management functions,” according to a letter from the Blue Cross and Blue Shield Association to the Energy and Commerce Committee. “If providers do not obtain consent, then health plans would not be able to use claims information for their own vital quality and management functions.”
Nor would providers be able to use data for analysis and reporting that patients haven’t given their consent to be used. “As a result, reports generated and conclusions drawn from data analysis for all of the quality, oversight, education and patient safety activities would be invalid because they were performed on an incomplete sample of patient records,” according to a separate letter the American Hospital Association sent to the Energy and Commerce Committee.
Timely, appropriate treatment would be another casualty of the expanded consent provision, says Barnes of the vendors’ association. “You’re going to really hold up treatment dramatically if you’re waiting on consent for every treatment and process,” he contends. “And then, you have to manage the consent process. Trying to figure out consent for every step in the food chain is almost impossible.”
Another provision of the bill would give patients the right to receive an accounting of all disclosures of electronic information for all purposes for up to three years prior to the date of the request. “I can’t even imagine the cost that will add to the design of information systems and storage of data,” Barnes adds. “A bill to incentivize I.T. will dramatically increase physician costs to adopt I.T.”
The legislation does call on the Department of Health and Human Services to develop regulations to implement expanded patient consent provisions “in a reasonable and workable manner.” But Barnes contends that Congress and HHS instead should focus on enforcing existing restrictions on use of patient information for marketing purposes.
Other concerns with the bill include provisions to create advisory committees on standards and I.T. policy, both of which many view as redundant, counterproductive and unnecessary.
And while the legislation would authorize $560 million in grants and loans to help providers adopt I.T., that falls “far short” of the need, according to the Alliance for Advancing Nonprofit Health Care.
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