Verma: Time to ‘reset’ EHRs to get to interoperability

December 1, 2017

After nearly a decade of regular use, it’s time to rethink and restart how physicians use electronic health records (EHRs), according to Seema Verma, administrator for the Centers for Medicare & Medicaid Services.

After nearly a decade of regular use, it’s time to rethink and restart how physicians use electronic health records (EHRs), according to Seema Verma, administrator for the Centers for Medicare & Medicaid Services.

 

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Speaking December 1 at the annual meeting of the Office for the National Coordinator for Health Information Technology (ONC) in Washington, D.C., Verma said she has heard a great deal of frustration on the part of physicians during her initial nine months in office.

Seema Verma

Feeling the systems were, “not built for them, but more suited as billing systems,” Verma said she understands that lack of user buy-in by physicians affects their job satisfaction, patient care and many of the initiatives generated by her office.

“We hear that physicians are taking time from patients [to deal with EHRs] and staring at computer screens,” said Verma.

This includes data required by the Medicare Quality Payment Program and the need to demonstrate value-based care by reporting patient outcomes.

She said in discussing data reporting for CMS with one hospital, it “turned my stomach” that the facility had to hire 18 people to manually extract information from its EHR versus having the technological means to collect and report the information required by CMS.

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“We are at the point that we need to reset and look at how we go forward,” Verma said regarding EHRs and data sharing. “Interoperability is critical … and we need to make it easy for patients to move around when it comes to their information.”

She used an example from her own life, when her husband suffered a cardiac arrest at an airport earlier this year. He underwent a barrage of tests to get a diagnosis. When it was time to leave the hospital and return to their home state-and home physicians-Verma said she asked for a copy of all the test results to share with her husband’s at-home care team.

“They [the physicians] all looked around at each other,” she said. “They didn’t know how to do it.”

Upon discharge, Verma left with a five-page discharge summary of her husband’s diagnosis and a CD-ROM, which by 2017 standards is antiquated technology.

“I wanted that information as it was part of his medical history,” she said. “That data should be our data.”

That latter sentiment feeds into a “patients first” focus Verma said CMS has implemented, at her direction, to stress patient engagement in the healthcare process. This runs the gamut from record access to being able to understand health plan options.

She also noted that the drive toward greater interoperability has larger implications. She highlighted President Donald Trump’s focus on the high price of prescription drugs as an example. With the administration exploring outcomes-based pricing, it is critical to get the information on patient progress.
 

“One of our main issues is getting interoperability for EHRs and making them responsive to providers,” Verma said. “…EHRs are a good thing and it’s good to move away from paper. It is a matter of how they are designed.”

She also acknowledged her agency’s role in impeding patient care in the form of the 11,000 pages of regulations CMS generates annually, saying it can “have a suffocating effect” on healthcare delivery in the U.S.

“And we are working on ideas on how to decrease that regulatory impact,” she said.