The Office of the National Coordinator for Health IT has released interoperability measures as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
The intent of the measures is to fulfill the requirement to “achieve widespread exchange of health information through interoperable certified electronic health record (EHR) technology nationwide” by Dec. 31, 2018.
Specifically, MACRA required the Department of Health and Human Services, in consultation with stakeholders, to create metrics for the exchange and use of clinical information to facilitate coordinated care and improve patient outcomes between participants in the Medicare and Medicaid Electronic Health Record Incentive Programs and others nationwide.
The deadline for establishing the metrics—July 1, 2016—was met by HHS and announced by HHS in a blog written by Seth Pazinski and Talisha Searcy, both directors in the Office of Planning, Evaluation and Analysis at ONC. According to ONC’s blog, the metrics are based on 100 comments received from healthcare and health IT organizations, as well as internal analysis.
“We have identified two measures in particular that satisfy both the feedback we received and MACRA’s specific parameters,” write Pazinski and Searcy in the ONC blog. “Importantly, these measures do not add to providers’ reporting burden as part of their participation in federal health care programs like Medicare or Medicaid, but rather come from existing national surveys of hospitals and office-based physicians.”
The two metrics are:
- The proportion of healthcare providers who are electronically engaging in the following core domains of interoperable exchange of health information: sending; receiving; finding (querying); and integrating information received from outside sources.
- The proportion of healthcare providers who report using the information they electronically receive from outside providers and sources for clinical decision making.
Section 106(b)(1)(B) of MACRA describes key components of interoperability that should be measured and the population that should be the focus of measurement, defining “widespread interoperability” as interoperability between certified EHR technology systems that are employed by meaningful EHR users.
“Although the MACRA requirement for measuring interoperability largely focuses on ‘meaningful users,’ we are committed to advancing interoperability of health information more broadly,” states the ONC blog. “We will be expanding our measurement efforts to include populations across the care continuum in the near-term, as well as an increased focus on outcomes in the longer-term.”
Nonetheless, ONC was quick to point out that the metrics are separate from the proposed Quality Payment Program that’s been proposed for the payment of office-based Medicare physicians.
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