The healthcare industry needs to catch up with other industries in fully leveraging information technology to drive innovation and advancements in care delivery, according to Karen DeSalvo, M.D., acting assistant secretary for health and national coordinator for health IT.
“It’s the information and technology age and it’s time for health and healthcare to come along,” said DeSalvo, speaking at a Dec. 3 Bipartisan Policy Center forum in Washington, D.C. “Even if you have significant chronic disease, most of your health experience happens outside of the doctor’s office or outside of the hospital. Being able to build a health IT platform that can enable and capture that for the consumer based on their own consent, their own expectations about who’s going to host that for them and in what ways will it be shared, is increasingly important and frankly is happening in other sectors and we need to get ahead of that in the health IT space.”
The country has reached a “tipping point” in the “adoption and adaption” of health IT with the meaningful use electronic health records program, DeSalvo believes. Likewise, Bill Frist, M.D., former U.S. senator and senior fellow and co-chair of the health project at the Bipartisan Policy Center, told the audience that currently approximately 44 percent of hospitals and 40 percent of physicians have adopted at least a basic EHR system. EHRs are helping to “inform and empower the patient in terms of clinical decision-making for themselves and in that engagement with their physician to put them on the right and correct track,” he argues.
However, DeSalvo makes the case that “as important and foundational as electronic health records are,” EHRs are only a part of the health IT ecosystem which is rapidly evolving with the growth of patient-generated health information. “It’s sort of like saying that your bank record is the picture of your financial health,” she said. “It’s a part of it. But, it’s not all of it. And, it’s the same thing in health and, as we evolve, we want to make sure we’re considering that and supporting it going forward.”
Toward that end, the Office of the National Coordinator for HIT is drafting a Federal Health IT Strategic Plan that will soon be released for 60 days of public comment. The primary goal of the 2011-2015 Federal Health IT Strategic Plan was to accelerate the adoption of EHRs and to facilitate information exchange to support meaningful use. However, the next iteration of the plan will set ONC’s priorities to advance technology beyond EHRs, according to DeSalvo.
“We have been working on an interoperability roadmap, which really is in many ways the way that we will execute on this strategic plan that calls for [data] collection across the care continuum, sharing of data so it can be put to use,” she says. The roadmap, DeSalvo reveals, will “speak” to an “interoperability of standards” and “how can we create a common data dictionary—a set of common data elements that we would all agree on.”
She adds: “We can start there and build—we don’t have to end there—but we have to start somewhere where it’s so much easier for developers, health systems, and new health IT to be able to exchange and interoperate data in a way that meets consumers’ expectations and consent.”
John Hammergren, CEO of McKesson Corporation, told the Bipartisan Policy Center forum that data interoperability is critical to the promise of health IT. “We will not accomplish our mission if we can’t share the data,” says Hammergren. “Imagine if you had a cell phone that only connected to your own service provider.”
For its part, McKesson and other health IT companies—including Allscripts, athenahealth, Cerner, and Greenway—launched in 2013 the CommonWell Health Alliance, a vendor-led initiative to enable query-based, clinical data sharing. Industry can “compete in an open and functional way that has cost and quality clearly as part of the decision criteria, but not a walled garden around our data that prevents its accurate use and utilization by all of the constituents in the healthcare system,” concludes Hammergren.
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