Inside the private sector’s role in the health IT opportunity
Federal healthcare leaders say the current state of health IT needs better coordination with the private sector. While progress is being made in the sharing of electronic patient data, there is still a pressing need for improvements in data exchange among providers, patients, and payers.
Those opinions came out during a panel discussion on Jan. 27. Modernizing Healthcare System and Interoperability in Government, hosted by immixGroup, featured three notable federal health IT experts:
- Ahmed Haque, director, Office of Programs and Engagement, Office of the National Coordinator for Health IT (ONC)
- Janet Vogel, director, Office of Information Services for Medicare & Medicaid Services (CMS)
- Joe Klosky, senior technical advisor and former chief technology officer, Food and Drug Administration
NEED FOR COLLABORATION, INCENTIVES
“Health care is broken,” said ONC’s Haque, noting that 18 percent of America’s GDP, or more than $3 trillion, goes to health care. Because the high expenses have historically yielded questionable quality, the government is moving to paying for value, not volume, he said.
Haque referred to the ONC’s Federal IT Strategic Plan (at this writing still open for comment), which proposes expanding health IT adoption through standards-based technology to securely exchange health information between patients, providers, and payers.
Advancing technical and scientific knowledge, Haque said, requires cooperative agreements with federal, state, business, and payers. That’s the underpinning of Health and Human Services Secretary Sylvia Mathews Burwell’s recent announcement on payment and delivery reform. HHS is closely considering how to move to a value-based model for funding, improving care and delivery (including how to pay for it), and sharing information for better health outcomes at lower cost.
CMS’s Vogel underscored that the government needs to incentivize the medical profession, to encourage providers and institutions to adopt new technology. She cited success with The Health Information Technology for Economic and Clinical Health (HITECH) Act to promote the adoption and “meaningful use” of health information technology.
CMS has paid over $6 billion in incentives for providers, and some $17 billion to critical care facilities, Vogel said.
Currently, according to Haque, 74 percent of medical professionals are “meaningful users” of health IT. “That’s not enough,” he said. The government needs private sector help in adopting practice transformation systems.
Beyond improving systems, Haque said, there’s a real need to engage consumers better and to encourage consumers to demand better service at lower cost.
Some headway has been made, he said. The Blue Button initiative, which allows patients to view their own health records online and download information, is a start. Patient-generated health data cannot yet be entered into the system, however, which limits its usefulness.
Haque also focused on the needs of rural Americans, commenting that those areas must have expanded broadband capability to ensure meaningful use through sharing information. The expansion of broadband and telehealth acceptance is particularly important for consumer engagement.
“Technology makes information sharing better,” Vogel said, but there’s a significant challenge in ensuring technology keeps pace with policy changes.
Integration is another challenge. Vogel pointed out that HITECH implementation is a system of systems that makes it difficult to meet deadlines and keep information current. This is further complicated by the need to balance a growing participant base against limited budgets.
Nonetheless, from the FDA perspective, technology continues to evolve and accelerative massively. FDA’s Klosky noted that data standards have helped the agency manage lines of business across enormous data sets. Having mineable health data and product quality information is essential for 50 percent of the FDA’s entire mission, he said.
The FDA conducts over 40 million inspections of raw materials and products annually. Risk engines determine how to use evaluation criteria and how inspections are done, Klosky said, and mobile technology is very important in helping to make determinations about material inspections.
INTEROPERABILITY AND DELIVER
When it comes to sharing health information, “Interoperability is vital to delivery,” Hague said. Interoperability and information exchange is essential at the state and community level, such as hospitals and small providers, as well as long-term care and behavioral facilities.
Clinical decisions from a patient’s health care providers must be in the EHR system whenever a patient enters a facility, Haque said. Not having the right patient history information makes for poor care and greater expense.