CHIME launches patient ID challenge

With help from Darius Tahir (@DariusTahir) and Arthur Allen (@ArthurAllen202 )

DRIVING THE DAY: CHIME’S PATIENT ID CHALLENGE: CHIME, the organization of health care CIOs, is formally launching its $1 million challenge to develop a fail-proof national patient identifier to link patients to their medical records. The Pro eHealth team will be on hand to pick up details of the challenge and prize later today at an event at the National Press Club.


Congress still has a ban on any federal work to create a national patient ID, but that doesn’t keep the private sector from tackling the issue with its own money. (We reported last fall that the Senate HELP Committee might mandate a report on patient matching in its forthcoming medical innovation bill. We haven't heard any confirmation recently).

HACKING MEDICAL DEVICES: The FDA is out with some guidance on the cybersecurity of medical devices. It says manufacturers of networked medical devices such as insulin pumps and internal pacemakers should continue to monitor their devices for cyber vulnerabilities after approval. The device makers should fix vulnerabilities as they arise and notify the FDA of any changes that could harm the product or the patient who uses it. The full document: http://1.usa.gov/1Q3wxyr

MORE REPORTS FOR YOUR PLEASURE: The Institute for Critical Infrastructure Technology is out with its own report on cybersecurity in health care, including a roundup of the usual threats and solutions: http://bit.ly/1PcxQON

— Related: HIMSS has launched its own Cybersecurity Community: http://bit.ly/1Q3H5Ob

eHealth tweet of the day: @CIOCHIME: Excited to have @onc_healthIT, @theNPSF join us for tomorrow's launch of the #NPIDchallenge! Watch the webcast. http://ow.ly/Xe0Bh

Welcome to Tuesday morning eHealth where your host spent most of the MLK holiday binge watching Making a Murderer on Netflix. It was much more appealing than cleaning house. Don’t tell me how it ends; I’m only halfway through. But pass along your news to [email protected] and connect with us on Twitter @ David_Pittman, @ arthurallen202, @ DariusTahir, @ POLITICOPro, @ Morning_eHealth.

NEXT STEPS ON MEANINGFUL USE: The Medicare Payment Advisory Commission, which met in D.C. last week, has passed along some initial thoughts on how last year’s Medicare and CHIP Reauthorization Act (MACRA) should be implemented. Here are some takeaways from the MedPAC meeting, Acting CMS Administrator Andy Slavitt’s J.P. Morgan speech, and what the two signify under current law.

HERE’S WHAT WE KNOW: Meaningful use will still be around, despite agitated suggestions to the contrary in the health IT trade press last week. MACRA states that EHR use will account for a quarter of physician performance score under the upcoming Merit-Based Incentive Payment System (MIPS). Doctors can receive penalties or bonuses of up to 4 percent starting in 2019, a number that grows to 9 percent by 2022, depending on how well they perform on MIPS.

WHAT WE DON’T KNOW:

Which meaningful use measures? Even the MedPAC staff Friday said they were clueless as to what CMS would require for the EHR use measures in MIPS. Slavitt gave some clues last week, saying CMS would move away from technology use and start rewarding outcomes. He also said providers would be able to customize their goals rather than the government dictating what must be done.

How many docs will be subject to MIPS? Those who have a certain percentage of their Medicare payments tied to alternative payment models are excluded from the MIPS program, but who will make the cut is still a large question mark. The MIPS and alternative payment model tracks appeal to different groups of providers for different reasons. And as MedPAC commissioners noted Friday, certain alternative payment models are targeted more squarely at primary care doctors.

What happens in 2017? MIPS would start in 2019, and like meaningful use, would be based on performances two years prior. That means that whatever EHR measures are included in payment adjustments would come from performance in 2017 (and from 2018, in 2020). That means it is almost impossible for doctors to avoid the dreaded Stage 3, because CMS won't be able to replace the program with finalized MIPS measures by the end of 2016 (Hence they won't be ready to be applied to the first year or two of MIPS).

What prompted Slavitt’s remarks? Few expected the acting CMS administrator to drop that bomb last week in San Francisco. CMS’s usual response to meaningful use criticism is a sober, “We’ll take your comments under consideration.” Did chagrin over the growing unpopularity of meaningful use cause Slavitt to blurt out those comments — or is he making CMS take a true "outside-in” look, as he said Monday?

WORTH A READ: Two internists deep in health IT policy write for the Health Affairs blog about where meaningful use has been and where MIPS is headed: http://bit.ly/1RpHXQt

MORE MACRA IMPLEMENTATION NEWS: “The American Medical Association, the National Association of ACOs and the American College of Physicians are among those lobbying the Obama administration to think more broadly about who should qualify for those bonus payments,” under the 2015 law, Pro Health Care’s Erin Mershon reports. In some of the same rulemaking that will outline MIPS and the new meaningful use, the Obama administration will also define what constitutes an “alternative payment model,” and with it, a 5 percent bonus in Medicare payments and exemption from the MIPS program. Groups like the AMA want all varieties of Medicare ACOs — even those taking less risk — to be included, but the doctor lobbyists doubt that will happen. Read Erin’s story here.

EHR VENDOR TRANSPARENCY FROM ONC: More beefed-up reporting requirements from ONC on EHR certification are now in effect. Requirements include more discourses about product costs, limitations on products’ ability to exchange information and other field-surveillance data. “Any deficiencies that investigators turn up will be posted within a week on the ONC's Certified Health IT Product List,” Pro’s Arthur Allen reported from Friday's advisory committee meeting. “The information will be used to alert users to problems, including safety concerns.” More on Arthur’s report here.

NO SURPRISE HERE: The American Academy of Family Physicians is out with a policy brief outlining the biggest barriers for doctors’ adoption of telemedicine. The findings: 54 percent cited lack of training, 53 percent pointed to lack of payment and 45 percent named cost of equipment as obstacles. http://bit.ly/1ZqeuVJ

PATIENT FORUMS — ARE THEY USEFUL?: Patients are increasingly turning to online forums for support and information, researchers in the Journal of Medical Internet Research point out. But their research, which reviewed WebMD forums from 2007 to 2014, found the quality of information in share links was low, thought they may provide emotional uplift or support. Forums centered on heart disease shared the most validated information; forums on ADHD shared “more controversial information sources.”

WHAT WE'RE CLICKING:

Is HIPAA hamstringing medical research like one former senator says?: http://bit.ly/1lfDhya

Medicaid IT systems jump into the 21 st century: http://bit.ly/1RNSuFs

Blues insurance plans adopt telemedicine for members: http://bit.ly/1P9bi1c

Tips, comments, suggestions? Send them along via email to our team: Arthur Allen ([email protected], @ArthurAllen202), David Pittman ([email protected], @David_Pittman) and Darius Tahir ([email protected], @DariusTahir).

Follow us on Twitter Mohana Ravindranath @ravindranize



Darius Tahir @dariustahir