Kramer dismisses these concerns. "We shouldn't be having a debate about whether the tools exist," he says. "The question is now, will clinicians use them to improve quality of care?"
Two Different Systems
There is a disconnect between the MIPS / MACRA push for physicians and what is happening on the hospital side of the equation.
"We have a completely unequal system right now," says Russ Branzell, president and CEO of the College of Healthcare Information Management Executives (CHIME).
"We have a system that gave leniencies to physicians, while at the same time not giving the same leniencies for the hospital-based side. Yes there are physicians, and a lot, that still work in a private practice setting, in a private environment, but wouldn't you want a harmonization of the entire system to be out there?"
According to Branzell, "we are still a long way from a universal set of clear, objective, clinical-based quality measures that we all agree on that should be used. "
"There's still a significant fragmentation out there that we have the opportunity to still bring together," he says.
CHIME's comments on the MACRA NPRM, filed in late June along with a torrent of other comments from stakeholders, mentions a long list of technology-related issues which could thwart MIPS and MACRA from achieving their aims.
In particular, CHIME is concerned that a provision of MACRA requires providers to attest they are not data blockers. In its MACRA comments, CHIME stated that while the nation still lacks a national patient identifier, "clinicians may experience matching patients to their records when records are exchanged; however, this should not be considered data blocking."
CHIME also considers immature technical standards a barrier to a second proposed attestation statement providers must sign under MACRA, basically stating that they are following applicable standards for successful implementation of MACRA and MIPS objectives.
Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.