After a decade of health IT adoption, the new national health IT leader, Karen DeSalvo, MD, thinks the “next chapter” of American medicine can be defined by its pursuit of innovation. If the government offers the right mix of policy, that is.
In the coming years, federal health leaders are striving to guide the nation toward a “learning health system, with a feedback loop where patient data is there across the continuum and can be used not just for care delivery but for quality and safety and evidence-based healthcare,” DeSalvo said at a HIT Standards Committee meeting.
To start that, DeSalvo said, the ONC and its policy committee that advises HHS are “taking a step back and looking forward for a multiyear trajectory where the big policy questions will be answered.”
That should come as a sigh of relief to many healthcare organizations seeking more breathing room in 2014, “the most stressful time in healthcare IT in our generation,” as summed up by John Halamka, MD, Beth Israel Deaconess Medical Center CIO and vice chair of the HIT Standards Committee.
The recent extended attestation period for the second phase of meaningful use stage 2 is also likely to be followed by another attempt to respond to providers needs: an 2015 EHR certification that tries to address shortfalls in this year’s certifications.
Sometime this month, HHS is going to publish a proposed rule for a 2015 EHR certification, said Jodi Daniel, director of the ONC’s office of policy and planning. This new certification would be voluntary for providers and vendors alike, she said.
“Providers would not — I’m going to say it again, would not — have to update to meet the meaningful use program,” Daniel said. “It would address issues we have heard about in the 2014 certification to hopefully make it simpler for folks to comply,” and it would also “reference updated standards and implementation guides that we hope will continue the momentum toward greater interoperability.”
The ONC’s interest in re-aligning long-term policy ideas, and the on-the-go tweaking for upcoming timelines, comes as Congress looks poised to consolidate the meaningful use, physician quality reporting and value-based payment modifier programs and eliminate related penalties as part of a new Medicare payment reform bill.
With Congress and bleary-eyed providers in the backdrop, the ONC and HHS are trying to “harmonize efforts and thinking on a longer-term horizon,” DeSalvo said. To that end, the agency is going to be working to fill gaps in health IT standards and interoperability — in part, as Halamka is arguing for, by approaching interoperability as a means to “empower innovation instead of prescriptive functionality.”
Health IT standards experts and stakeholders are at work on standards for several such use cases, as Doug Fridsma, MD, the ONC’s chief science officer and standards guru, outlined.
One use is a targeted query of patient records: for instance, “where you know the patient was seen in an emergency room last night and you want to take a look at the final CT scan.”
Another is data migration and patient portability, if a patient is moving from one provider to another and needs to have their records transferred between two (likely different) electronic record systems.
Depending on the relationship of the providers, any existing interfaces or the work of a regional or statewide health information exchange, that could be lengthy process, especially for medical practices.
“One wonders if there’s a way that we can streamline that process,” Fridsma said.
Anthony Brino the editor of HIEWatch, and covers health policy for Government Health IT and insurance for Healthcare Payer News.