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美国MU进入第三阶段:HIMSS提议政府减少指令性和复杂性

来源:HIT专家网   沈建苗 译

22近日,HIMSS向美国卫生福利部提交了有意义使用第3阶段(Meaningful Use Stage 3)提议规则和2015年版医疗IT认证标准方面的意见函。这两封信函分别发给了医疗保险和医疗补助服务中心(CMS)的代理主任安迪•斯拉维特(Andy Slavitt)和全国医疗IT协调员卡伦•B•德萨尔沃(Karen B. DeSalvo)博士,竭力建议医疗保险和医疗补助服务中心(CMS)以及全国医疗IT协调员办公室(ONC)做好下列工作:

  • 减弱电子健康档案激励计划的指令性;

  • 加大对该计划早期确立的实质性功能的关注;

  • 降低2015年认证标准的复杂性。

HIMSS表示,它将继续支持有意义使用计划,因为这一工具可以积极地改变美国的医疗保健业。意见函认为,有意义使用是“积极改变医疗保健业的重要工具”,并提到了HIMSS的分析数据――每年收集的数据涉及所有非联邦性质的美国医院以及3万多家美国门诊机构。数据表明,70%的医院在过去的五年推进电子健康档案的功能方面取得了积极进展;60%以上的门诊机构在过去的三年同样取得了积极进展。

HIMSS重申了一贯以来的态度:支持互操作性。HIMSS致力于打造这种文化,即IT是改变医疗保健、提高医疗质量、改善患者体验、控制成本、提高医疗服务普及程度以及优化公共支付有效性的立足之本。

HIMSS回复CMS有意义使用第3阶段的全面意见如下:

  • HIMSS仍然全身心致力于减弱电子健康档案奖励计划的指令性,更专注于鼓励和帮助医疗服务机构充分利用有意义使用第1阶段和第2阶段中确立的实质性功能,包括互操作性。

  • HIMSS赞许法规制定提案公告(NPRM)中的一项提案,从2018年开始对有意义使用有一个统一的定义,不管医疗服务机构何时开始参与电子健康档案奖励计划。

  • HIMSS支持CMS开展的工作:将电子健康档案奖励计划与同样使用认证医疗IT的其他CMS质量报告计划结合起来。HIMSS认为,这方面的工作会减轻医疗服务机构的负担。

  • HIMSS致力于确保患者安全仍是开发、实施和广泛使用医疗IT系统的重中之重。

  • HIMSS重申了一贯以来的主张:18个月是有意义使用、认证和标准方面出台最终规则与有意义使用的任何阶段开始启动之间所需的最短时间。18个月的时间表让有关部门可以帮助对医疗服务机构在即将到来的新阶段方面进行教育,并作好准备。这18个月的时间不包括2017年和2018年有意义使用第3阶段转型的时间。

HIMSS关于2015年版医疗IT认证标准的全部意见包括如下:

  • ONC必须克服2015年版认证规则的总体复杂性,为此要减少标准总数量以及所包含标准和功能的数量。

  • HIMSS承认,ONC和CMS在各自的NPRM中试图降低2015年版认证标准和有意义使用第3阶段的需求的复杂性。然而,考虑到这一NPRM中包括的所有新需求,HIMSS建议ONC重新考虑2015年版认证标准所需要的需求,并考虑有什么方法可以尽量减少和简化所提供的选择。

  • HIMSS仍然谨慎地支持ONC制定运用医疗IT的创新认证和测试计划这项工作。支持学习型医疗系统的认证必须内容具体、精心规划,并且侧重于对互操作性有最大影响,又与规划性目标紧密结合的方面。

  • ONC或另一政府部门应该先确立规划性目标,然后再开始启动与这项工作有关的任何认证计划。认真评估认证标准,并与满足相应计划的目标必不可少的功能结合起来,这点很重要。

  • 面对认证涵盖的诸多计划,HIMSS支持更协调更一致。

  • HIMSS支持这一想法:评估认证计划时,将诸标准之间的采用级别和成熟级别作为一个重要的考量因素。

HIMSS会继续密切关注CMS有意义使用第3阶段计划和2015年版医疗IT认证标准方面的进度。想了解最新信息,请访问HIMSS政策中心网站

【HIMSS简介】

HIMSS是一家跨国的公益性非营利机构,致力于通过信息技术来改善医疗。HIMSS积极致力于使用信息技术,优化保健服务和医疗效果。HIMSS是一家公益性跨国企业,在全球各地提供医疗IT思想领导地位、教育、事件策划、市场研究和媒体服务。HIMSS创办于1961年,服务对象超过58000人,三分之二供职于全球各地的医疗服务机构、政府部门和非营利机构,另外还与一起从事这项伟大事业的640多家公司和400家非营利性组织合作。HIMSS的总部位于芝加哥,在美国、欧洲和亚洲均设有办事处,服务于全球医疗IT行业。

【参考原文】

HIMSS submitted comments to the Department of Health and Human Services on  the Meaningful Use Stage 3 proposed rule and the 2015 Edition Health IT Certification Criteria.  The two letters, sent to Acting CMS Administrator, Andrew Slavitt, and National Coordinator for Health IT, Dr. Karen DeSalvo, respectively, strongly urge CMS and ONC to:

 

  • Decrease the prescriptive nature of the EHR Incentive program,
  • Increase focus on the substantial capabilities established earlier in the program, and
  • Reduce complexity in the 2015 Certification Criteria.

HIMSS voiced its continued support for the Meaningful Use Program as a tool to positively transform health and healthcare in the United States. Identifying meaningful use as a “critical tool for enabling healthcare transformation,” the response cites HIMSS Analytics data – collected annually on all non-federal US hospitals, and more than 30,000 tethered US ambulatory facilities – that “70% of hospitals have made a positive progression in the advancement of their EHR capabilities over the last five years, with over 60% of ambulatory facilities showing similar progress in the last three years.”

HIMSS reiterated its long-standing commitment to interoperability:  “HIMSS is committed to a culture in which IT is fundamental to transforming healthcare; improving quality of care, enhancing the patient experience, containing cost, improving access to care, and optimizing effectiveness of public payment.”

The full comments on HIMSS response to the CMS Meaningful Use Stage 3 include:

  • HIMSS remains strongly committed to making the Electronic Health Record Incentive program less prescriptive and more focused on encouraging and assisting providers to take advantage of the substantial capabilities established in Meaningful Use Stages 1 and 2, including interoperability.
  • HIMSS applauds a proposal in the NPRM for a single definition of Meaningful Use starting in calendar year 2018, no matter when a provider began to participate in the EHR Incentive Program.
  • HIMSS supports the work being done by CMS to align the EHR Incentive Program with other CMS quality reporting programs that also use certified health IT.  HIMSS believes such efforts will lessen the burden on providers.
  • HIMSS is committed to ensuring patient safety remains paramount to the development, implementation, and wide-spread use of health IT systems.
  • HIMSS reiterates its long-standing assertion that 18 months is the minimum length of time needed between the final rules on Meaningful Use, certification, and standards, and the start of any stage of Meaningful Use.  An 18-month timeline allows stakeholders to help educate and prepare providers on the upcoming new stage.  The current timeline for transitioning to Meaningful Use, Stage 3 in 2017 and 2018 does not include 18 months.

The full HIMSS comments  on the 2015 Edition Health IT Certification Criteria include:

  • ONC must address the overall complexity of the 2015 Edition Certification Rule by reducing the total number of criterion, as well as the standards and functionalities included.
  • HIMSS acknowledges that ONC and CMS attempted to reduce the complexity of the requirements for the 2015 edition certification criteria and Meaningful Use Stage 3 in their respective NPRMs for this cycle.  However, given all the new requirements included in this NPRM, HIMSS urges ONC to reconsider the requirements needed for the 2015 edition certification criteria and consider approaches to minimize and simplify the options presented.
  • HIMSS remains cautiously supportive of ONC’s efforts to establish innovative certification and testing programs that utilize health IT.  Certification in support of a Learning Health System must be specific, carefully planned, focused on the areas that have the greatest impact on interoperability, and closely aligned with programmatic goals.
  • ONC or another agency should establish the programmatic goals before commencing with any certification program associated with the effort.  It is important that certification criteria be closely evaluated and aligned with the functionalities necessary to meet the goals of the program in question as the move continues beyond EHR-specific certification.
  • HIMSS supports greater harmonization and alignment across the programs covered by certification.
  • HIMSS supports the idea of including the level of adoption and maturity among standards as an important consideration when evaluating inclusions for certification programs.

HIMSS will continue to monitor the progress on CMS Meaningful Use Stage 3 program and the 2015 Edition Health IT Certification Criteria. Look for updated information at the Policy Center on the HIMSS website. 

About HIMSS

HIMSS is a global, cause-based, not-for-profit organization focused on better health through information technology (IT). HIMSS leads efforts to optimize health engagements and care outcomes using information technology.

HIMSS is a cause-based, global enterprise producing health IT thought leadership, education, events, market research and media services around the world. Founded in 1961, HIMSS encompasses more than 58,000 individuals, of which more than two-thirds work in healthcare provider, governmental and not-for-profit organizations across the globe, plus over 640 corporations and 400 not-for-profit partner organizations, that share this cause.  HIMSS, headquartered in Chicago, serves the global health IT community with additional offices in the United States, Europe, and Asia.

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未经允许不得转载:HIT专家网 » 美国MU进入第三阶段:HIMSS提议政府减少指令性和复杂性
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