Senate: Health care IT bill will ‘end unfair practices’ for patients, providers

The U.S. Senate Committee on Health, Education, Labor and Pensions unanimously recommended a measure designed to improve health care information technology.

The purpose of the "Improving Health Information Techonology Act" (S. 2511) is to simplify information sharing among doctors and allow patients easier access to their own medical records. The bill focuses on the use of the electronic health record — a real-time digital version of a patient’s medical chart — to allow for central record keeping of a patient’s entire medical history, including medications prescribed, treatment plans, immunization records, allergies, radiology imaging and lab results. The goal is to allow immediate and secure access to all authorized users, including patients and providers.

Lamar Alexander

Patty Murray

“This was not a subject that I intended to spend much time on this year,” Committee Chairman Lamar Alexander, R-Tenn., said during an executive session. “But the more we got into it, the more I saw that the program was in a ditch, and we might have the opportunity to help us get it out of the ditch.”

Sen. Alexander co-sponsored the bill with Sen. Patty Murray, D-Wash., who is the committee’s Ranking Member.

During the committee meeting, Alexander highlighted the key goals of S. 2511, which included:

The reduction of time spent by doctors on paperwork, some of which may be superfluous;
Aiding hospitals and health care providers gain a better understanding of the information technology products they use;
The reduction of “information blocking,” which delays the sharing of health information between providers; and
The achievement of system interoperability, which would allow patients better access to their own records.

Provider burden

According to data from Woolhandler and colleagues published in Annals of Family Medicine, physicians reported spending 16.6% of their working day performing administrative duties, including charting and dictation.

“We should go out to the doctors of the country and say, ‘If you’re spending 50% of your time filling out forms, then either you’re doing something wrong or we’re doing something wrong,’” Alexander said. “Let’s work together to fix that. I think the physicians of this country would have appreciated that and would begin to see electronic medical records as an aid, rather than something they dread.”

The programs used to capture electronic health data appeared to be another area of concern for the committee. Many hospitals and medical offices do not fully understand the software they buy, according to Alexander.

Under S. 2511, the Senate will partner with the Department of Health and Human Services to “educate health care providers on ways in which to leverage the capabilities of health information exchanges (or other relevant platforms) to provide patients with access to their electronic health information.”

Electronic health records also will be an important part of new physician payment system under development by President Obama and Secretary of Health and Human Services Sylvia Mathews Burwell, Alexander said.

“It seems to me that it would make sense during this next year to work with the doctors and align electronic health care records … with this new incentive system,” he said.

Patient access to records

S. 2511 intends to “clarify misunderstandings by health care providers about using health information exchanges (or other relevant platforms) for patient access to electronic health information.”

“My medical health information is mine,” Alexander said. “That is the law. But most Americans don’t really understand that and have a difficult time gaining access to their own information.”

The bill would focus on reducing “information blocking,” or the occurrence of a provider refusing to share information or charging a fee, or when two electronic health care systems are not compatible for sharing data. Thus, a goal of the bill is to improve system interoperability and communication.

Sen. Murray emphasized that the bill will strongly benefit both patients and clinicians.

“The Improving Health IT Act would make it easier for providers to vote with their feet when it comes to electronic health record systems and end the unfair practice of information blocking,” Murray said. “It will offer new tools to help move the market for health IT toward more usable products that can easily share information when a provider needs it and encourage better patient access to their own health records so they can be more empowered to make informed healthcare decisions with their doctors.”

Sen. Bill Cassidy, R-La., applauded the committee for prioritizing the bill. Cassidy — who worked as a medical doctor before his election to the Senate — said that the bill would have significant positive implications for practitioners.

“A group of physicians have said that they’ve come up with an electronic health record that is faster than paper,” Cassidy said during the session. “That should be our goal. The rural family practitioner — the one-person practice — needs to be as fast as paper if she is going to have a lifestyle and take care of her patients.”

Concerns

However, some committee members expressed concerns regarding the electronic health record

“Although I think this has been a terrific process and a great piece of legislation, there is a lot more to be done in this area,” Sen. Sheldon Whitehouse, D-R.I., said during the session.

Sheldon Whitehouse

Sen. Whitehouse identified three remaining areas of concern, the majority of which centered on issues of "meaningful use." According to data obtained from www.healthit.gov, meaningful use is defined as “using certified electronic health record technology to improve quality, safety, efficiency, and reduce health disparities; engage patients and families; improve care coordination, and population and public health; and maintaining privacy and security of patient health information.”

The areas enumerated by Sen. Whitehouse included:

providing additional support to health information exchanges, rather than relying solely on meaningful use;
minimizing the effects of federal privacy statutes that predate electronic health records; and
helping behavioral health programs and nursing homes, which fall outside the parameters of meaningful use.

“We have taken an important step forward,” Whitehouse said. “But it is the first step.”

Alexander noted that S. 2511 possessed crucial implications for President Barack Obama’s Precision Medicine Initiative.

“The Precision Medicine Initiative absolutely depends on the success of electronic medical records,” Alexander said. “Most of what we are advocating depends on that.” – by Cameron Kelsall

References:

S. 2511, 114th Congress. 2016. Available at: www.gpo.gov/fdsys/pkg/BILLS-114s2511is/pdf/BILLS-114s2511is.pdf. Accessed Feb. 11, 2016.

Woolhandler S and Himmelstein DU. Int J Health Serv. 2014;doi:10.2190/HS.44.4.a.