March 7, 2018
By James Swann
Medicare’s recently announced initiative to improve patient access to medical records earned cautious praise from industry, which is still waiting for key details on the program.
The initiative is part of an overall Medicare push to give patients more control over their own health-care data, as well as allowing the data to be shared with providers, but the impact is unclear at this point.
The move is certainly a step in the right direction, but it’s not a game-changer, Marcy Wilder, a health-care privacy and cybersecurity attorney with Hogan Lovells in Washington, told Bloomberg Law.
Bringing together industry stakeholders and calling on private insurance plans to make their data accessible to patients can help, but on their own aren’t likely to move the needle too much toward full electronic health-data exchange, Wilder said.
Government officials rolled out the medical records initiative, known as My HealthEData, at the Healthcare Information and Management Systems Society in Las Vegas on March 6.
However, Medicare’s upgraded Blue Button program will make Medicare claims data more accessible, Wilder said, which would be a significant change.
Centers for Medicare & Medicaid Services Administrator Seema Verma said Blue Button 2.0 is a standards-based application programming interface that will let Medicare beneficiaries access their claims data through secure apps or services.
Blue Button was first used by veterans and was later adopted by Medicare to give beneficiaries access to their medical records.
Verma was introduced at the conference by Jared Kushner, who heads up the White House Office of American Innovation. The office was created a year ago with the mission of making recommendations to the president on how to improve government services.
The White House didn’t respond to a request for an interview with Kushner.
The rationale behind the CMS announcement is commendable, but it remains to be seen how it’s implemented, Eric Chan, a health-care attorney with Hooper, Lundy & Bookman in Los Angeles, told Bloomberg Law.
“I think a player like Apple, with its recent announcement to create a medical record using FHIR [the Fast Healthcare Interoperability Resources standard] protocols, has a better shot at enabling widespread patient access to medical records,” Chan said.
The CMS said it’ll work with Congress to ease EHR requirements, as well as focus on interoperability, Chan said, but hasn’t identified any specific initiatives yet.
The announcement includes additional details aimed at giving patients more control over their medical data, Ellen Janos, a health-care attorney with Mintz, Levin, Cohn, Ferris, Glovsky and Popeo PC, in Washington, told Bloomberg Law.
For example, Janos said the CMS would require providers to keep their EHR systems updated to ensure data can be shared with other providers, and would require hospitals to share a discharged patient’s medical records with the post-acute provider.
“This is a very important step toward ensuring that patients experience a seamless transition when moving from one provider to another,” Janos said.
The My HealthEData initiative doesn’t specifically mention the Health Insurance Portability and Accountability Act, but it could reduce the number of authorization forms patients need to sign under HIPAA to transfer their data, depending on how it’s implemented, Vanessa Burrows, a health-care attorney with McDermott Will & Emery in Washington, told Bloomberg Law.
Clarifying what types of information about a discharged patient must be shared by a hospital with a patient’s follow-up provider may cut down on the forms patients must currently sign to transfer their records or request copies, Burrows said.
Private insurance plan efforts to open up access to data have been hampered by a lack of data, but the CMS initiative will stimulate better data sharing, Bruce Broussard, chief executive officer of Humana Inc., said on a press call after the announcement.
Data sharing will let doctors have better conversations with patients and help improve health outcomes, Broussard said.
Broussard was joined on the call by Paul Markovich, chief executive officer of Blue Shield of California, who said the CMS move coincided with the need to bring health-care into the digital age.
Markovich said the CMS announcement gives the insurance industry the push it needs to create better data sharing and build a comprehensive, real-time data-sharing platform.
Blue Shield has been working with Manifest MedEx to promote data sharing, Markovich said, and said Blue Shield will require all of its providers to sign a contract with Manifest.
Manifest is the largest nonprofit health information exchange network in California.
Health-care data have been imprisoned for far too long, John Doerr, a partner with California-based venture capital firm Kleiner Perkins Caufield & Byers, said on the call.
There’s a large opportunity to make use of health-care data, and it’s likely that the number of available health-care apps will surge due to the CMS efforts, Doerr said.
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