Kicking off the Office of the National Coordinator for Health IT’s (ONC) third annual meeting in Washington, D.C., on Dec. 12, Farzad Mostashari, M.D., told attendees that despite all the progress they have made to transform the healthcare system, the journey is really just beginning.
Mostashari, the national coordinator for health IT, acknowledged the significance of ONC’s accomplishments. “Last year, we put on a big push on meaningful use. We now have 81 percent of hospitals registered for the meaningful use program,” he said, “and the majority have already received incentive payments.” Sixty-two percent of eligible providers in the country have signed up as well, he added. “There have been big necessary changes that have come to healthcare in the last three years,” he added. “The framework is right; the foundation and building blocks are there. But we have to get so much better.”
He stressed that for providers, meaningful use must go beyond just doing the minimum to check the boxes and earn an incentive. “It is not enough to have adoption of systems, certified products, attestations to meaningful use. It’s not enough to have improvements in process measures,” he added. “We have to help doctors, hospitals, and patients make it meaningful.” He listed off several examples of clinics using registries to focus on decreasing the number of patients with out-of-range A1C levels or an AIDS task force prioritizing patients in greatest need of additional care. He wants clinicians to take ownership of the quality measures for their own purposes rather than for reporting up to payment entities. “We have to help them make it meaningful for actual coordination of care and enabling new models of care and patient engagement,” he said.
U.S. Chief Technology Officer Todd Park has said that the biggest barrier to change in healthcare is the cultural belief it can’t change. Pointing to the Beacon Community efforts, Mostashari said they have “ripped the shroud from the belief that healthcare can’t change.” That wall of belief is paper thin, he said, and the Beacons are punching holes in it, until “only tattered remnants of that wall remain.”
During a panel discussion on interoperability, John Halamka, M.D., CIO of Beth Israel Deaconess Medical Center in Boston and co-chair of the HIT Standards Committee, said that he believes that two years from now, many interoperability issues will be resolved and that electronic health records (EHRs) will be able to talk to each other. He said that meaningful use Stage 2 provides the policy, technology, and incentives to move vendors and providers in that direction and that eventually patients will demand it. Halamka noted that the Commonwealth of Massachusetts recently lit up its statewide HIE, so that soon patients will never have to shuttle paper between providers again.
On another panel moderated by CTO Todd Park, Craig Samitt, M.D., president and CEO of integrated health system Dean Clinic in Wisconsin, spoke about the power of analytics and transparency of data internally to change physician behavior and improve performance. “We are using claims data and EHR data to profile physicians and do internal comparisons. “We might notice how Dr. X, Dr. Y and Dr. Z. do very different things with common diagnoses. We show it to them and say, ‘we’re confused. Can you help us develop a protocol to improve our overall performance?”
Health systems can’t reward value unless they measure and report on it, he added. “If we reward value, we need to be able to link incentives to accurate data.”