‘Trailblazer’ states draw ONC help
December 20, 2012 in Medical Technology
The Office of the National Coordinator for Health IT and the National Academy for State Health Policy are working together to help “trailblazer” states better align their health IT activities with healthcare delivery system reform efforts.
The goal is for a quality reporting, improvement and feedback infrastructure and assistance for eight states, starting with Massachusetts, Oregon, Minnesota, and Arkansas. Such an infrastructure would combine data from multiple sources in a single system to serve a number of programs. Rhode Island, California, Michigan, and possibly Maine may join the second phase.
These states were selected because they are already performing activities that begin to line up health IT with healthcare delivery transformation immediately, according to Kelly Cronin, healthcare reform coordinator at ONC.
State healthcare leaders believe the adoption of health IT is at a tipping point and that they can translate some of their investments to get improved outcomes as building blocks for their delivery system reform. But not all state government high-tech implementation is aligned around their thinking for payment and delivery reform and recognizing the need to break down the silos.
[See also: CMS posts quality measures for 2014 MU.]
State leaders are concerned there are too many measures across commercial and public programs, “reporting fatigue and a tsunami of data,” Cronin said at a meeting earlier this month of the federal advisory Health IT Policy Committee. Feedback is scattered and too difficult to be actionable, particularly when it is geared for silos of patients and populations. Other plans and providers are reluctant to share their data, believing that data is a private commodity rather than a public good.
NASHP has described in a document the issues and strategies that some states are using to capitalize on health IT to improve their healthcare system.
“An ecosystem is needed to be figured out to make this work, but they also know there has to be a business case around it. We can’t just create a series of intermediaries that are qualified and reporters of valid quality measures that are comparable across systems and that can provide actionable feedback. There also has to be sustainable business models for them,” Cronin said.
The underlying issue is how to use performance data at the provider level, even at the point of care, and to have timely and comprehensive feedback.
The alignment of measures is becoming increasingly important to reduce reporting burden, and these governors want to put in place new payment systems, whether it’s through scaling a patient-centered medical home model, multi-payer accountable care organizations (ACOs) or some combination of bundled payments with these other models.
“But the idea of getting alignments on e-measures that could be computable and feed into this eco-system and be functional for these programs is critical,” she said, adding that “we’d like to figure out how this might work in a couple of states and then have this model inform how other states can do it too.”
A place to begin is with the growth of meaningful use of electronic health records.