Patient information would be captured and used in order to reduce health disparities in Stage 3 of the electronic health records meaningful use program, according to recommendations adopted on March 11 by the Health IT Policy Committee.

Capture of expanded demographic information is one of the 19 objectives in a Stage 3 proposal the advisory committee has sent to the Department of Health and Human Services. Under this objective, the certification criteria to achieve the goal of reducing health disparities would be the ability to capture occupation and industry codes, as well as sexual orientation, gender identity, and disability status.

"Reducing disparities is one of our most important objectives and we can't do it if we don't know what those disparities are," said George Hripcsak, co-chair of the HIT Policy Committee's Meaningful Use Workgroup. Capturing the information, however, should not be mandatory, he noted.

"Privacy issues were raised in the past and this does not mean that the provider is forcing the patient to answer these questions, nor are we forcing the provider to ask them in the first place. We simply want the provider for whom these questions are important to their practice to have a place in the electronic health record to record the answers to these questions." 

However, the Stage 3 objective calls for clinical quality measures requirements that would include a requirement to stratify one CQM report by a disparity relevant to the provider, said Paul Tang, co-chair of the HIT Policy Committee's Meaningful Use Workgroup.

"What we proposed was for the provider to select a CQM and stratify it by a disparity variable that's important in their locale," stated Tang. "So, you can better understand how your populations are being cared for and what the outcomes are so that you can target improvements to a specific group."

The HIT Policy Committee's approval of the Stage 3 demographics/patient information objective comes just a couple of weeks after 24 members of Congress sent a letter to Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner and National Coordinator for Health IT Karen DeSalvo, urging them to reduce health disparities through the development of the Stage 3 meaningful use criteria. Specifically, the lawmakers made four recommendations to CMS and ONC: improve data collection, improve data use, improve health literacy and communication, and improve access. 

"The reduction of health disparities is one of the stated goals of the Health Information Technology for Economic and Clinical Health Act," wrote the legislators in their Feb. 21 letter. "As regulations regarding the Stage 3 Meaningful Use criteria are promulgated, we ask that you incorporate these recommendations to not only give weight to that goal, but to make a positive life-altering impact for the nation's underserved and vulnerable populations."

HHS hopes to publish a proposed Stage 3 rule this fall with a final rule in the first half of 2015.

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