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In Health Affairs Blog, DeSalvo, Washington Share Ambitions for an Interoperable Future

October 2, 2016
by Mark Hagland
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A new Health Affairs blog by Drs. DeSalvo and Washington shares thoughts on what will be needed to create an interoperable future

The immediate past National Coordinator for Health IT and the recently appointed National Coordinator for Health IT on Sep. 29 co-authored a blog online in Health Affairs touting the gains made in the adoption of electronic health records (EHRs) made in the years since the passage and implementation of the HITECH (Health Information Technology for Economic and Clinical Health) Act in 2009, and laying out their vision of a more digitally interoperable healthcare system. Writing on Sunday in the Health Affairs Blog, Karen DeSalvo, M.D. and Vindell Washington, M.D., the immediate past and current National Coordinators, highlighted the near-universalization of EHR adoption among U.S. hospitals and physician practices, while sharing thoughts on what elements will be needed to push forward the interoperability of healthcare information going forward.

Drs. DeSalvo and Vindell wrote that, “Over the past seven years, the United States has seen a historic health IT transformation, moving from a primarily paper-based health system to one where virtually everyone has a digital footprint of their care because of the dramatic uptake of electronic health records (EHRs). Recent data have helped quantify just how rapidly technology has transformed clinical settings. Today,” they noted, “nearly all hospitals (96 percent) and nearly eight in 10 (78 percent) physicians use certified EHRs. This transformation is the result of 2009’s Health Information Technology for Economic and Clinical Health (HITECH) Act, when fewer than one in 10 hospitals and 17 percent of physicians used EHRs. This rapid uptake of technology reflects the unyielding effort by clinicians and health systems across the board who helped usher in this new era of medicine. The result of this effort is a vast amount of electronic health data now exists which simply did not seven years ago.”

What’s more, DeSalvo and Vindell wrote in Health Affairs, “This transformation represents more than simply digitizing paper health records. It also puts us at a global competitive advantage and is leading to real-world impacts in the clinical setting. Systematic reviews of academic literature found that 84 percent of studies showed that certified EHRs had a positive or mixed positive effect on quality, safety, and efficiency of care. Other recent studies found that EHRs can reduce adverse events among cardiovascular, surgery, and pneumonia patients and that switching EHRs did not result in adverse safety events.”

As the federal officials noted, “These results reflect the vision we laid out in two key documents last year when we collaborated with more than 35 federal partners to develop the Federal Health IT Strategic Plan 2015-2020, and joined forces with the private sector to develop A Shared Nationwide Interoperability Roadmap, which outlines milestones, calls to action, and commitments that public and private stakeholders should focus on achieving, particularly in the near-term, to continue making progress.”

Moving forward, DeSalvo and Vindell wrote, it is the goal of federal officials at the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), and Office of the National Coordinator for Health IT (ONC) to create a “learning, person-centered health system,” one that helps the healthcare system to shift from the initial-adoption phase of the past few years to a more advanced phase involving “improving patient experiences and health outcomes” through EHR and other clinical information systems.

To do this, they write, ONC will focus on partnering with public and private partners to accelerate true interoperability of health information, via the following means: “the use of common, federally recognized, national standards; changing the culture around access to information—including combating data blocking; and, building the business case for interoperability.” They add that, “To achieve these goals, the Administration is leveraging impactful tools: delivery system reforms that drive a business case for interoperability; new guidance on the Health Insurance Portability and Accountability Act (HIPAA) to make providers and individuals aware of patients’ rights to access and transmit their data; and requiring publishing application programming interfaces (APIs) to enhance the connectivity between EHRs and provider and consumer applications.”