The healthcare industry should aim to achieve health information interoperability sooner than the timeline outlined by the Office of the National Coordinator for Health Information Technology’s (ONC) 10-year roadmap, more specifically, by December 31, 2018, according to the Healthcare Leadership Council (HLC).
That recommendation is part of a comprehensive report on the healthcare industry titled “Viable Solutions: Six Steps to Transform Healthcare Now” and is the result of HLC’s National Dialogue for Healthcare Innovation (NDHI) initiative. The HLC report stated that in order to meet that deadline, which is three years away, the nation must achieve nationwide exchange of health information through interoperable certified electronic health records (EHRs) technologies.
According to the report, NDHI participants identified challenges to achieving full-system interoperability, including conflicting and competing standards, the need for dissemination of emerging best practices in patient identification and matching, the lack of consensus on clinical workflow and payment reform best practices, and the complex provider collaborations involved in new delivery and payment models.
“According to NDHI participants, this date of December 31, 2018 is achievable if driven by the private sector and the parameters and barriers noted above are sufficiently addressed,” the report stated.
HLC is a coalition of chief executives from various disciplines in the healthcare industry, including payers, providers, manufacturers and health information technology firms, and its NDHI initiative is a platform through which various health industry sectors collaborate with patients, employers, academicians and government to examine, discuss and build consensus on how to address issues affecting the course of 21st century healthcare progress.
In March 2015, under the auspices of NDHI, leaders of more than 70 healthcare organizations, including the U.S. Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS) and the U.S. Food and Drug Administration (FDA), convened to identify the barriers impeding progress toward a high-value, innovation-driven healthcare system, according to HLC.
“NDHI participants came to the conclusion that healthcare in the U.S. can be significantly improved by focusing on actions that are readily achievable via legislation, regulation, or voluntary actions by various health system players. Positive health system transformation does not require a wholesale remaking of health delivery structures, but rather the enabling and acceleration of patient-centered innovation,” the report stated.
According to the report, the companies, organizations, and policy experts participating in the NDHI process agreed on six policy recommendations to improve U.S. healthcare:
- Comprehensive care planning
- Medication therapy management
- Health information interoperability
- Changes to federal anti-kickback and physician self-referral (Stark) laws
- Health information flow improvements focused on patient privacy laws and regulations
- Food and Drug Administration (FDA) reforms
In the area of health information interoperability, the NDHI initiative supports the establishment of a December 31, 2018 deadline for health information interoperability, “on or before which the nation must achieve nationwide exchange of health information through interoperable certified EHR technologies.
“Consumers should also have easy and secure access to their electronic health information, be able to direct it to any desired location, learn how their information can be shared and used, and be assured that this information will be effectively and safely used to benefit their health and that of their community,” the report stated as another key goal.
Following the summit and to continue work on these six steps, NDHI participants established three workgroups focusing on the following areas: patient engagement and adherence, data strategy and electronic health records (EHRs) interoperability and outdated and/or ineffective laws and regulations.
“The workgroups collaborated throughout 2015 to agree upon policy approaches that transcend the theoretical and are viewed as clearly achievable, whether through legislation, regulatory action, or proactive steps initiated by healthcare organizations. What emerged from this process is a blueprint that will be offered to executive and legislative branch policymakers and healthcare leaders,” the report authors wrote.
In the area of interoperability, the HLC report notes that “while challenges still remain, the past decade has brought tremendous progress towards the adoption and meaningful use of health IT.” And the report authors state that since the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, there have been several major efforts by the public and private sectors to move toward an interoperable healthcare system.
“All stakeholders agree on the fundamental components of interoperability, but definitions of and timing for national interoperability differ, the report authors stated.
The HLC report notes the Office of the National Coordinator for Health Information Technology’s (ONC) Interoperability Roadmap released in October outlines a vision for interoperability with a timeline and private/public sector opportunities for achieving the goals of interoperability. However, the ONC Interoperability Roadmap is a 10-year roadmap that lays out a plan to achieve nationwide interoperability by 2024.
The HLC report outlines a more ambitious goal with a national objective to achieve widespread exchange of health information through interoperable EHR technology nationwide on or before December 31, 2018, which is in parallel to the recommendation made in the Medicare Access and CHIP Reauthorization Act.
“NDHI believes that, by bringing together the ideas and technological expertise from both the public and private sectors, interoperability is an achievable goal that can and should be accelerated through innovation and partnership between government and the private sector,” the report stated.
The HLC report also outlined a number of other recommendations for policymakers in the area of health information interoperability:
- Policymakers should encourage exchange of material and meaningful health data through the use of technologies and applications that enable bidirectional and real-time exchange of health data currently residing in EHR systems (e.g. open and secure API technology).
- Policymakers should use appropriate authority to certify only those EHR technology products that do not block or otherwise inhibit health information exchange. ONC should decertify Meaningful Use products that intentionally block the sharing of information, or that create structural, technical or financial impediments or disincentives to the sharing of information.
- The federal government, in collaboration with the private sector, should build on current and emerging best practices in patient identification and matching to identify solutions to ensure the accuracy of every patient’s identity; and the availability and accessibility of their information, absent lengthy and costly efforts, whenever and wherever care is needed.
- Any interoperability requirements or incentives should be “technology neutral” and focused on outcomes—active interoperation between and among systems—rather than on adoption or use of specified technologies. It is critical that future policies do not stifle potential innovations in health system connectivity.
The HLC stated that the recommendations in the report are intended to “drive health system transformation and a movement toward value and innovation."
"The consensus viewpoints contained in this report are also consistent with steps currently being taken by the federal government to guide a health system transition from fee-for-service to pay-for-value and toward more integrated, coordinated care. These recommendations should serve as a catalyst for further debate and decisive action," the report stated.
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