June 15, 2015
Secretary Sylvia Matthews Burwell
Acting Administrator Andy Slavitt, Centers for Medicare and Medicaid Services
National Coordinator Karen DeSalvo, M.D., Office of the National Coordinator for Health IT
U.S. Department of Health and Human Services
200 Independence Avenue SW
Washington, D.C. 20201
Re:
Formal Comments on Meaningful Use Stage 2 Rulemaking
File No. CMS-3311-P
Dear Secretary Burwell, Acting Administrator Slavitt, and Dr. DeSalvo:
We the undersigned organizations and individuals read with dismay that CMS intends to no
longer require that 5 percent of patients view, download or transmit their health information or
send a secure message to their providers. Instead, CMS proposes that doctors and hospitals
merely show that just one patient used online access to their information, and that secure
messaging was merely turned on, not whether any patient has actually used it. We are deeply
disappointed in CMS’s reversal of these critical commitments to patient and family engagement.
Every available piece of survey data shows that 5 percent is more than achievable. In fact, CMS
itself reports that median performance is 32 percent of patients for doctors and 11 percent of
patients for hospitals on Stage 2’s measure of actual online access.1
According to a national survey, of all patients who have online access, 86 percent use it, and 55
percent use it at least three times per year. A majority (56%) of patients want the ability to email
their providers.2
HHS’s national initiative on delivery system reform cannot possibly succeed without active
engagement of patients and family caregivers, and online access is a critical tool for so many.
The more frequently individuals access their health information online, the more they report that
it motivates them to do something to improve their health (71% for frequent users, compared
with 39% for infrequent users).3 Online access to personal health information is a cornerstone of
better care, smarter spending and healthier people.
A minimum standard of 5 percent signals a genuine expectation by CMS, and is meaningful
enough to drive real progress in patient and family engagement. Dropping to just one patient,
and merely turning secure messaging on, signals a drastic change in CMS’s expectations of
providers and patient engagement. We urge you to reverse these proposed changes
immediately.
Sincerely,
Alliance4Health
American Association on Health and Disability
American Health Information Management Association (AHIMA)
Asian and Pacific Islander American Health Forum
Association for Healthcare Documentation Integrity (AHDI)
1
Association of Asian Pacific Community Health Organizations
Bechtel Health
California Pan-Ethnic Health Network
Caregiver Action Network
Caring From a Distance
Center for Democracy & Technology
Center for Medical Consumers
Center of Health Engagement
Colorado Consumer Health Initiative
Consumer Federation of America
Disability Rights Education and Defense Fund (DREDF)
Families USA
Genetic Alliance
Get Real Health
Global Liver Institute
Healthwise
Health Data Consortium
Health Record Banking Alliance
Informed Medical Decisions Foundation
Intel Corporation
Joseph H. Kanter Family Foundation
Justice in Aging
Lakeshore Foundation
Lee Memorial Health System
National Alliance for Caregiving
National Association for Trusted Exchange (NATE)
National Health IT Collaborative for the Underserved
National Health Law Program
National Partnership for Women & Families
New England Regional Genetics Group (NERGG)
Pacific Business Group on Health
Society for Participatory Medicine
The Empowered Patient Coalition
The Institute for Family Health
United Leukodystrophy Foundation.
Unpatient.org
Wilson Disease Association
And the following individuals from across the nation:
1.
Dave deBronkart, "e-Patient Dave"
2.
Donna R Cryer, JD
3.
Aneesh Chopra
4.
Arien Malec, VP RelayHealth and father to a son with a serious health condition
5.
Amy Gleason
6.
Loran Cook
7.
Christine Bechtel
8.
Rebecca Coelius, MD
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Nick Dawson, MHA
Anneliz Hannan
David Harlow, JD MPH
Joshua Rubin
Barbara Harrison
Carla Berg
Peter Elias, MD
Ann Waldo
Jerrie Abshire
Matt Good
Erin Mackay, MPH
Emily Dore
MaryAnne Sterling
Shannah Koss
Steven W. Chapkin
Sherry Reynolds
Casey Quinlan
Philip Marshall MD, MPH
Leonard Kish
Alisa Foti
Mark Savage
Danielle Malia Edwards.
Gabriela Sabaté, CEO, Health Semantics
Neil S Calman, MD
Heidi Bayer
Christina Caraballo
Howard David Taylor, Jr.
Adrienne White, MBA BSMT (ASCP)
Sandra Sebbas
Dena Mendelsohn, JD, MPH
Cyndy Nayer
Tucker Ball
Erma Lewis
Anne Roda
Cynthia Conner
Stephen La Serra
Bert Cisneros
James Toy
Marilyn Winters
Mary Angela Hudson
Mariu Suarez
William G. Gonzalez
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Christy Lewis
Anna Barker
Katherine Mauldin
Terrence Ward
Anna Juhaniewicz
Sandra Alyabari
Dave Popoff
Eleanor Burden
J. Angell
Bridgette Belle
Cynthia Howells
Greg Darmenio
Florence Portell
Sean Drakes
Kevin Laliberte
Pamela Joseph
Ferold Torchenot
Ty Petersen
Sarah Baethge
Richard Bigelow
Emma Spurgin Hussey
Fay Gunn
Ronald Daniels
Heather Holmes
Vincent Harriman
Nancy Hoop
John C. McMahon
Ralph Glick
Susan Gibilisco
Theresa Tyler
Joy Bunton
Howard Pellett
Matthew Tarpley
Jon Madden
Catherine McMahon
Jean Millay
Howard Cohen
Rebecca Abadie
Matthew Atterberry
Belinda Yealy
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Alan Katzer
Kaitlin Fitch
Michelle Benes
Debbie Lange
Allison Fradkin
Lawrence Padilla
Leonard Edwards
William C. Henry
Marc LaComb
Julie Martin
Catherine Christeller, M.S.
Thomas J. Bailey, J.R.
Ruth Braithwaite
Marty Mason
Russell Manning
Jerry Amos
Daniel Deren
Kicab Castaneda-Mendez
Gloriamarie Amalfitano
Marjorie Streeter
Jolianne Baum
Tracy S Troth
Martha M.
Donna Carswell
Deborah Schechter
Todd Corbett
Diane Watters
Karen Jones
Thomas Forsyth
Alan Keith
Susan Epler, RN
Elizabeth Cerny
Jeri Nussbaum
Alice Polesky
Otmar Jonas
Jeffrey Shuben
David Teague
Leonard Greene
Katya Peterson
Bob Brucker
Wanda Bass
Betty Lawrence
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Roxanne Scheidt
Richard Stern
Wendy Portman
Karole Friemann
John Harvey
Michelle Wyer
Ella Smith
Susan Pederson
Marian Ellette
Ira Dember
Rose Barragan
K.G.H. Nicholes
Laura Willey
Kara Graul
Janet Warfield
Mary Ann Hilgeman
Debra Gleason
Evalyn Narramore
Karen Boutwell
Kay M.
Margie Nobbman
Frank Luzzo
Russ Gladstone
David Hurley
William Malone
Jane Herron
Thomas Dukes
Anne Pompeer
Dave Griswold
Paula E. Brady-Muniak
Dawn Albanese
James Higgins
Denise Recalde
Jane Anne Gleason
John Stoltenberg
Martha Stoltenberg
Emily Lubahn
G. Hardiman
Jay Unger
Natalie Van Leekwijck
Robert Watson
Lonnie Albrecht
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Penelope Mazza
Janis Spencer
Rev. Dr. Curt Miner
Reevyn Aronson
Joseph Braus
Gene Marie Mastropierro
Allen Vogt
Thomas Mosby
William Nichols
Kirk Gardner
Christopher Lawrence
Stacey Gunderson
Eva Gasser-Sanz
Bea Kreloff
Anna Cushman
Kelly Wright
Sharon Blackman
James Blackman
Robert Woods
Tia Pearson
Chris Loo
Stephen Dempsey
Richard Longley
Ruth Weedman
Marjorie Moss
Denise Janssen Eager
Geri Creque
Ralph Browning
Thea Constantine
Sherry Sharpnack
Gerald St. Germaine
Geoff Richcreek
Shirley Powell
C. Born
John Markowitz
Frank Daversa
Leo Kucewicz
Dwight Jeffery
Pamela Bryson
Colleen McGlone
Jan Elliott
Roberta LaFrance
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Anpeo Carpenter
David Jones
Elaine Bauer
Evelyn Missey
Robert Soto
Michael Oatman
Lauren Wade
Bernadette Monaghan
Virginia Gilbert
Maureen O'Neal
Elaine Becker
Rebecca Barclay
Ted Pratt
Tamar Raine
Terry Dailey
Kathy Spera
Linda Roberts
Mary Kalinowski
Yolanda Whiteside
Cheryl-Ann Weekes
Michael Kast
Jane Beattie
Mary Butler
Rev. Sylvia Niedner
Clyde Atwood
Naira Hueper
Tim Linderman
Rebecca Koo
Carolyn Berry
Lee Allbright
Debbi Coltharp
Alyssa Anderson
Victoria Lavin
Laura Fisher
Laurie Pisarcik Connolly
Steven Kostis
Christinia Montegue
Kathy Johnson
John Wienert
Sally Ramirez
David Clifford
Brie Gyncild
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Erika Hamer
Sandy Hall
Frank Creneti
Ken Mauney
Ronald Wieschowski
Herma Diaz
Diane Thompson
Pamela Stearley
Mike Dotson
Christina Bernard
K. Kay
William Schoene
Ricardo Aguiluz
Marion Walls
Delores Eddins
Janet Dougherty
Eusebio Manuel Vestias Pecurto Vestias
Phillip Mixon
Michael Adame
Folakemi Adekugbe
Barry Greenhill
A. M. Heines
Karlene Gunter
Eneshal Miller
Jimmy Silin
Myra Garland
Jay Chen
Donald Jacobson
Becca Greenstein
Daphne Figueroa
Nanci Nelson
Michael J. Bellmore
Diana D.
Javier Del Valle
Linda Hubbard
William Swatos
Suzanne Heller-Culver
Jean Johnson
Michael Lombardi
Emily Walter
Samantha Cranko
Terrance Chadd
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Lynne Chapman
Brian Houser
1 Centers for Medicare & Medicaid Services (CMS), Data and Program Reports, available at https://www.cms.gov/Regulations-andGuidance/Legislation/EHRIncentivePrograms/DataAndReports.html .
2 National Partnership for Women & Families, Engaging Patients and Families: How Consumers Value and Use Health IT (Dec. 2014), available at
http://www.nationalpartnership.org/research-library/health-care/HIT/engaging-patients-and-families.pdf.
3 Ibid.
10