House of Representatives set to vote today on 21st Century Cures bill

After 2 years of legislative wrangling, the House of Representatives is all ready to vote today on the 21^st Century Cures Act bill involving various health IT provisions created to deal the issues of electronic health record usability, interoperability, and data blocking.

Speaking on the floor of the Senate yesterday in advance of today’s House vote, Sen. Lamar Alexander (R-Tenn.) applauded the legislation’s $6.3 billion in appropriations to support the Obama administration’s Cancer Moonshot ($1.8 billion), Brain Research through Advancing Innovative Neuro technologies ($1.6 billion), and Precision Medicine Initiative ($1.4 billion). The bill finds to speed the approval of latest medicines and medical devices, among other provisions.

Alexander, chairman of the Senate health committee, also termed out the 21st Century Cures bill’s attempts to make better the health IT. Noting that the federal government has spent more than $30 billion on incentives to get providers to accept electronic health records (EHRs), he charged that EHR systems are a “mess” and desperately require fixing.

“Various portions of the bill concentrate on 2 critical areas where improvement is required to better leverage health IT and EHRs to their full potential,” claims Ben Moscovitch, manager of HIT at The Pew Charitable Trusts. “Those 2 areas are enhanced interoperability and improved usability and patient safety.”

Deficiency of testing rules would annoy EHR oversight of ONC

A latest regulation from the Office of the National Coordinator (ONC) for Health Information Technology created to increase federal EHR oversight needs better testing requirements for electronic health record vendors. Because lack of testing rules could annoy EHR oversight of ONC.

Without an upgrade in testing needs, the rule will attempt to acquire its stated goal of making better the patient safety, claims Ben Moscovitch, manager of health IT at The Pew Charitable Trusts. Moscovitch authored a report giving an assessment of ONC’s Enhanced Oversight and Accountability Rule released previous month.

In theory, the regulation would determine ONC to analyze electronic health records or EHR oversight suspected of posing crucial risks to sufferers, need the developer of an electronic health record to correct identified errors, and, if important, suspend the certification of products with unresolved problems.

 “Sadly, even with this rule in place, gaps persist in the capability of providers, hospitals, vendors, and other agencies to gain data on the safety implications of electronic health record usability and establish best practices to deal safety errors that are identified,” claims Moscovitch.

In accordance to Moscovitch, the issue is that the ONC’s new rule needs just limited testing of EHRs to monitor for flaws before the products are installed, and no comprehensive system exists to gather data on safety problems regarded to these records.

To deal these problems, he makes two suggestions to help detect and prevent safety issues during the development and execution of EHRs, while decreasing patient harm related to these products:

• ONC should need vendors to better test EHRs for safety before their products are brought to market and after the products have been installed and customized at facilities. This would assist to reduce the requirement for the agency to perform a straight review of an installed product, because errors or mistakes would have a higher likelihood of detection beforehand.

• EHR vendors, government, clinicians, hospitals, patient agencies, and other healthcare stakeholders should come together to recognize the most common and important safety issues associated with electronic health records and work together on solutions as well as disseminate those great practices.

When it comes to the 2^nd suggestion, Moscovitch claims that he would like to see Congress pass legislation to develop a Health IT Safety Collaborative, which an expert panel from the Institute of Medicine recommended creating in the year of 2011.

On the day of December 6, ONC and The Pew Charitable Trusts will co-host a Health IT Safety Day in the Washington to identify the root causes of and solutions to patient safety flaws linked with EHRs. Particularly, the meeting will look at how the EHR certification criteria and testing programs can assist to improve patient safety and how the federal government and private sector can advance the establishment of a HIT Safety Collaborative.