Todd Park, chief technology officer at the Department of Health and Human Services (HHS), spoke on a discussion panel on Wednesday morning at the Microsoft Connected Health Conference, being held April 27-28 at the McCormick Place convention center in Chicago. Afterwards,HCI Editor-in-Chief Mark Hagland was able to obtain an exclusive interview with Park (who was named HHS CTO in August 2009, and arrived at the federal agency following a previous stint as co-founder of the Watertown, Mass.-based Athenahealth), and was able to ask him about his perspectives and intentions around accountable care organizations (ACOs) under the federal Patient Protection and Affordable Care Act (PPACA) legislation introducing healthcare reform, meaningful use under the federal American Reinvestment and Recovery Act/Health Information Technology for Economic and Clinical Health (ARRA-HITECH) Act. Below are excerpts from that interview.
Can you share with us your perspectives on the IT and other requirements coming out of the PPACA with regard to accountable care organizations, and the meaningful use requirements under the HITECH Act, and how you see those requirements aligning?
There’s a very exciting shift underway toward accountable care in all of its forms. This to me is finally rewarding providers for improvements in quality, efficiency, and health; because until recently, there was a negative impact for providing those things. So having a payment system that rewards improvements in population health and in efficiency, is a big, emerging breakthrough. There are a lot of innovations that are now on a broad scale that are helping to improve patients’ health and outcomes, and efficiency. And in my mind, the role of IT is to support that.
And in terms of meaningful use, and accountable care systems, the goal has to be to align everything, and we are explicitly seeking to do that. I also think that as part of that, and it’s an important additional theme to stress, is that it’s really important for health information to move wherever a patient goes, and that patients need to be able to access their own information; and on an accelerating basis, that will spawn a growing ecosystem of innovation, which will help consumers better manage their own health. I would guess that a lot of that [innovation] is going to be advanced by providers, as they engage patients through accountable care, medical homes, and so forth; so they’ll be a very compelling source of these applications to help consumers.
One issue that many provider leaders I’ve spoken with since the release of the ACO proposed rule at the end of last month, keep mentioning, is the clause that allows patients being cared for by ACOs to opt out of having their information shared among the entities participating in ACOs. And this appears to be so even when those patients are brought into those ACOs by the Medicare program. Can you speak to providers’ concern around this?
Given that the ACO is a reg that is in the process of evolving, I should probably hold off on commenting directly. But we are intensely interested in input across the board, and HHS is going to respond to providers’ concerns. We will listen to providers’ IT and data-sharing concerns, and all their other concerns as well. It’s incredibly important.
As providers go forward under the ACO program and meaningful use, what do you see as the challenges facing them?
To morph from an operation that was successful under a fee-for-service system to one under accountable care, those are very different places to be; and that transition requires process change, culture change, and management change, as well as technological change. But I think providers will rise to the challenge. A lot of providers have always wanted to be in the place, particularly primary care providers, where they will be in the place of providing coordinated care and keeping people healthy. And that notion is actually very much in line with the souls of docs. So that is something we very much have going for us as a country. And this is one of the things I was talking about on the panel; there are a whole bunch of companies that have helped develop and are developing services that can help providers make the jump to accountable care.
Can you commit that you’ll help providers with regard to making sure that the requirements and mandates that come out of HHS will match those coming out of ONC [the Office of the National Coordinator for Health Information Technology], wherever possible?
We are very focused on coordination across the department, to make sure that the pieces fit together; that’s obviously our goal. I’m constantly talking with Dr. Mostashari [Farzad Mostashari, M.D., national coordinator for health information technology] at ONC, with CMS [the Centers for Medicare & Medicaid Services], and with [others in] our office; it’s a team [across HHS], and we know that it’s actually in the combination of the efforts is where gains will be made.
What would your advice be for providers right now, at a time of intense change in healthcare?
While it’s tumultuous, it’s also a time of great opportunity. And it’s a very exciting time to be an innovator in healthcare, precisely because it’s a time of disruptive change. Because the system does have to change to bring us to where it has to be in terms of outcomes, health [status], and affordability. And disruptive times are the most exciting times for change. And I look forward to providers to lead the way as innovators, as we lead to a better and better healthcare system. So I would say, seize the moment!