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Post-HIMSS13: Are We at an Inflection Point in U.S. Healthcare IT?

March 17, 2013
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With a week-and-a-half’s remove from HIMSS13, it’s possible to put everything into perspective, and a number of themes emerge, all of them related to the theme of clarity


In the midst of the crazed swirl of the annual HIMSS Conference, it can be challenging for any attendee to keep everything in perspective at any particular moment, with events and information rushing at one at warp speed. And this year’s conference, held March 3-7 at the Ernest N. Morial Convention Center in New Orleans, was no exception, with frenetic activity on all levels and across so many dimensions.

But with a week-and-a-half’s distance from the frenetic activity of the conference, it’s possible to look back at HIMSS13 and see things in a broader context. And a number of themes emerge, all of them, in my view, falling under the broad heading of clarity. Let’s look at the varieties of clarity one by one.

Policy clarity at the forefront

Indeed, the policy clarity coming out of the conference, based on very clear signals sent to the industry by federal healthcare officials, more or less put everything else into clarity by extension. When a joint announcement coming out of the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (HITECH) was published on the morning of Wednesday, March 6, just before the speech given by CMS acting administrator Marilyn Tavenner, R.N., and then a press conference by Farzad Mostashari, M.D., national coordinator for health IT, everything fell into place on the policy front.

Federal health officials themselves described the 2013 goals of the Department of Health and Human Services (HHS), the umbrella federal healthcare agency, as “aggressive,” among them pushing for the goal of 50 percent of physician offices using EHRs and 80 percent of eligible hospitals receiving meaningful use payments, by the end of 2013; increasing the emphasis on interoperability; enhancing the effectiveness of EHRs through programs like Blue Button; and “underscor[ing] program integrity,” including through audits of EHR-driven coding on the part of providers.

Ms. Tavenner and Dr. Mostashari confirmed their agenda in their remarks to the public and the press that morning. As Tavenner put it in her speech immediately after the release of the HHS healthcare IT agenda on Wednesday morning, “What I can say is that I am truly committed to health IT as a platform and a strategy for the work ahead of us at CMS. We have made so many strides, and the progress is truly amazing.” She underscored her commitment to thoughtful but firm progress forward by announcing that no Stage 3 preliminary rule for meaningful use would be released before the end of calendar year 2013, a signal that HHS/CMS/ONC were going to, as she put it, “take time to digest” input and feedback from the field about Stage 2 of meaningful use before pushing on to Stage 3.

And then Dr. Mostashari further reinforced the message when he said at his press conference held immediately after the Tavenner public presentation, “The administration is absolutely committed to health information technology as a platform for payment and delivery reforms, and that we can really cannot succeed in shifting payment and delivery models from volume to value without having information technology as a platform and as a strategy.” He then went on to discuss the ways in which the level of computing capability available to providers successfully moving through MU Stage 2 was already robust enough to support key federal healthcare reform initiatives, including avoidable readmissions reduction and state-level payment and care delivery innovations.

As I noted in a blog on March 7, the logic of that policy agenda is fairly unassailable, and really, what the HHS announcement called an “aggressive” agenda seems imminently reasonable, given the context in which it was made: a healthcare system about to go over a demographically induced cost cliff, attached to a policy and political system reeling from a series of federal budget showdowns, given fundamental differences in perspective between the two major political parties in this country. In short, we need the increased effectiveness in healthcare delivery coming from automation more desperately and urgently than ever. Could anyone really argue with that core assertion?

Industry and technology clarity next?