Washington, DC – Today, the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) held a hearing to explore how the federal government can improve the use of electronic health records (EHRs). Among the expert witnesses testifying at the hearing was Meryl Moss, Chief Operating Officer at Coastal Medical in Providence, RI. Moss was invited to testify by Sen. Sheldon Whitehouse (D-RI), who is a member of the committee and has long been one of the Senate’s leading voices on the promise of health information technology such as EHRs. His work on the issue dates back to 2001 when he founded the Rhode Island Quality Institute during his time as Attorney General.
Today’s hearing was part of a series organized by HELP Committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) to identify ways that Congress and the Administration can improve electronic medical records – either through legislation or administrative action. The discussion at the hearing focused largely on what health care providers need in order to make EHRs simpler to adopt and more effective for patients – from adjusting the “Meaningful Use” requirement that providers must meet in order to receive federal EHR incentive payments, to enabling various networks to more easily share information.
Whitehouse focused his remarks and questioning on the need to improve information sharing. “On a lot of these issues, if we empower the local health information exchange – if we empower CurrentCare in Rhode Island and if we empower MiHIN in Michigan – they can be a forum for sorting through a lot of those issues without having to get the federal government engaged in doing a national thing. Obviously you want some national standards that they comport with, but in terms of the application I’d love to see state-by-state, network-by-network a lot of exciting work being done to try to coordinate in these areas. But it’s hard for us to do that when the support for, say CurrentCare, is so intermittent and so weak compared to the river of money that flows into Meaningful Use.”
Whitehouse also introduced Moss, saying, “It’s my pleasure to introduce our witness from Rhode Island, Meryl Moss. Meryl is Chief Operating Officer of Coastal Medical, a primary care driven Accountable Care Organization that cares for 120,000 patients at 20 offices across Rhode Island… I’m delighted that she could come down here.”
Moss recommended several areas of improvement to the Committee, including harmonizing the various quality measures that providers are required to meet. “The government uses one set of measures for CMS ACOs and a different set for Meaningful Use. Insurers require us to achieve different quality targets and these are ever-changing. NCQA requires different measures as well. All are good, but many are overlapping. This just creates unnecessary complexity and confusion.”
Video of the entire hearing is archived here.
Electronic health records have the potential to make health care more efficient while also reducing costs by limiting medical errors, among other things. In one example that helped inspire Whitehouse’s work in the Senate, a Rhode Islander named Mike Tracy was diagnosed with squamous cell carcinoma on his foot after several years of misdiagnoses. Tracy then traveled to Boston for a second opinion before agreeing to the recommended surgery – having his foot amputated to prevent the spread of the cancer. However, Tracy’s final diagnosis was delayed several weeks in order for his complete records to be transferred from Providence. His surgery was eventually successful, but as Tracy said in 2008 when he attended the State of the Union address with Whitehouse, “[p]aper medical records meant I had to wait in limbo – knowing my life was in danger – while my chart was transferred from one hospital to another.”
In 2009 Whitehouse helped secure new investments for health information technology through the American Recovery and Reinvestment Act (ARRA), including a provision to establish a “Regional Extension Center Program” to support the adoption of EHRs. The Rhode Island Quality Institute received more than $6 million through that program, along with additional funding from two other ARRA health information technology programs. Rhode Island was the only state to receive all three ARRA health information technology grants, and is now recognized as a national leader in the adoption of EHRs. More recently, Whitehouse helped convene state health care leaders – including Coastal Medical – to develop a series of recommendations for Governor Raimondo and the General Assembly to pursue, which included expanding incentives for EHR adoption and utilization targets.
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