The HHS National Coordinator for HIT and Acting Assistant Secretary for Health, Karen B. DeSalvo, MD, MPH, MSc, delivered the keynote address at Brookings Institution’s www.Brookings.edu March 4, 2015 event “Can Forces Align to Use Health IT to Improve Care and Lower Costs?” The speakers at the event discussed the successes and problems related to health IT in terms of standards, interoperability, expanding payment models, and meaningful use.
According to Dr. DeSalvo, ONC www.healthit.gov has been actively involved in standard development and on January 30th released a draft of their “2015 Interoperability Standards Advisory: the best available standards and implementation specifications”.
The Standards Advisory describes ONC’s assessment of the best available technical standards and implementation specifications for clinical health information technology interoperability as of December 2014. The Standards Advisory also provides industry with a single public list of the standards and implementation specifications.
The next step is to create incentives that will motivate the use of the standards, so there will be rules on how to govern people’s electronic health information, how it will be collected, shared, used, and how privacy and security will be protected.
Also, reported by Dr. DeSalvo, on January 30th, ONC released the draft document “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Version 1.0.” The draft roadmap is a proposal on how to deliver better care that will result in healthier people through safe and secure exchange by using electronic health information.
To further expand on payment issues, on February 27th Patrick Conway CMS Deputy Administrator for Innovation and Quality and Chief Medical Officer along with Dr. DeSalvo invited private payers, employers, providers, patients, states, consumer groups, individual consumers, and other partners within the healthcare community to participate in the “Health Care Payment Learning and Action Network”.
The Network was first announced on January 26th by Secretary Burwell, to support the transformation of the nation’s healthcare delivery system to achieve better care, smarter spending, and healthier people through the expansion of new healthcare payment models.
To kick off the Network on March 25, 2015, a live streaming will be held. Participants will need to register online at http://innovation.cms.gov/initiatives/Health-Care-Payment-Learning-and-Action-Network to receive further details.
Peter Basch, MD, FACP, Visiting Scholar in Economic Studies at the Engelberg Center at Brookings and an internist practicing in Washington D.C. pointed out that the full promise of health IT has not yet been fulfilled and does not yet benefit all Americans.
Dr Basch along with Christopher Botts, Program Manager for Health Care Reform, and Mark B. McClellan, MD, PhD, Senior Fellow and Director of the Initiatives on Value and Innovation in Health Care, presented their views in an article appearing in the current “Health360” www.brookings.edu/blogs/health360 blog.
The co-authors agree that to date, the Meaningful Use (MU) program has been successful in leading to substantial adoption of EHRs by healthcare providers across the U.S. Approximately half of U.S providers now use EHRs that are MU certified. MU has also been credited as being largely responsible for the rapid adoption of e-prescribing and the increased use of HIEs.
However, the blog points out that despite progress on adoption, many providers do not believe that certified EHRs have significantly reduced their practice burden. Providers are also critical of MU for reliance on a general set of specific mandatory functions and workflows that define data collection. They also think that the EHR capabilities now available may not be a good fit with their most pressing practice needs.
The blog authors summarize key challenges in terms of defining uniform requirements, developing specific process-driven measures, prioritizing access to accurate actionable information related to coverage and payment, and finding ways to achieve effective interoperability.