eHI spells out its own data sharing plan

November 14, 2014 in Medical Technology

As the Office of the National Coordinator for Health Information Technology refines its 10-year vision for interoperability, a diverse coalition of private and public interests has put forth its own ideas for transforming U.S. healthcare through IT.

[See also: eHI report shows growth in health data exchanges]

The eHealth Initiative on Thursday released the first in a series of documents making up its “2020 Roadmap,” spelling out its priorities, goals and areas of broad agreement for achieving the Triple Aim of safer care, improved population health and lower costs.

While certainly critical of the direction of the federal meaningful use program, this portion of the roadmap, entitled, “Part 1: National Priorities, Goals and Areas for Consensus,” doesn’t just pile on. It also offers suggestions — albeit broad concepts rather than specific prescriptions — for accelerating momentum toward the true goal, the Triple Aim.

[See also: Interoperability 'taking so darn long']

“A tremendous amount of money, time and resources has been invested into health information technology efforts,” wrote eHealth Initiative CEO Jennifer Covich Bordenick in her introduction to the document. “Despite all this time and money, many healthcare leaders question the direction in which the public and private sectors are currently heading and raising concerns about the slow pace of improving the care quality and achieving cost reductions.

The 2020 Roadmap “was born out of these concerns,” said Bordenick Thursday during a teleconference with reporters. “It’s all about creating a shared vision for transforming our health system through technology.”

During the call, Steven J. Stack, MD, president-elect of the American Medical Association, cited a 2013 Rand Corp. report for the AMA that described how EHRs often distract physicians from direct patient care and are not interoperable enough to deliver the right information on the right patient to the right place at the right time. “It’s our deep and sincere hope that the eHI roadmap makes meaningful use meaningful,” Stack said.

Stack, who serves as eHI secretary, said that the roadmap is “far more comprehensive” than meaningful use and is “less cumbersome and intrusive.”

John Glaser, CEO of Siemens Health Services said that there was no question meaningful use has been a “huge accelerant” of EHR adoption.

“However, we are at a time that the program has to evolve” to focus on patient outcomes, he said. Under the proposed ONC vision, EHRs would not start widely producing better outcomes before 2020.

Still, Glaser said there is a “critical federal role” in the realms of standards and privacy protection.

This first part of the eHI roadmap concentrates on business and clinical motivators for health IT usage, interoperability of health IT systems and data access and use.

According to Bordenick, the process began with an industry survey in May. eHI identified strategic priorities in July, then followed up with a meeting involving about 150 executives from various segments of the healthcare industry before producing this document.

The eHI vision for aligning business and clinical motivators includes:

  • “Meaningful” incentives to engage consumers in their own care, with information and technology to support shared decision-making;
  • Financial incentives to deliver safe, efficient care and better outcomes;
  • Health IT incentives that focus on care outcomes rather than “feature function” and involve the entire continuum of care;
  • Financing and incentive programs that take a “measured approach to health IT implementation that enables delivery system transformation at an effective and feasible pace”;
  • Incentives to standardize data collection and exchange across all care settings; and
  • Regulation that offers “sufficient space and flexibility for entrepreneurial innovation while ensuring that important patient-consumer and healthcare provider needs are addressed.”

In the realm of interoperability, the group seeks:

  • A secure, interoperable framework to enable patient-centered care in a “high-performing” healthcare system;
  • Data flow that ” directly enables the most comprehensive, patient-centered, safe, efficient, effective, timely and equitable delivery of care” at the point of care; and
  • Information that improves the healthcare experience for individuals, reduce health disparities, measure outcomes, deliver better value, improve population health, support public-health surveillance, aid the evolution of standards of care and inform research into new treatments.

Appropriate data access and use, according to eHI, should:

  • Give consumers confidence that their personal health information is “private, secure and used with their consent in appropriate, beneficial ways”;
  • Have policies and business rules that encourage trust and transparency among new technologies;
  • Include policies and procedures to ensure the integrity, security and confidentiality of personal health information;
  • Have monitoring of compliance with privacy and security standards and appropriate reporting of breaches to affected consumers; and
  • Make sure consumers come to view and trust health information exchange as a “critical component of high-quality, safe and efficient healthcare.”

“The private sector really needs to lead the way in many of these areas,” Bordenick said. This could include private payers offering incentives separate from meaningful use, data sharing and vendors collaborating to harmonize data standards. “Healthcare is an intertwined series of problems and the solutions need to be the same.”

Bordenick said the eHealth Initiative will work with ONC as that office finalizes its “vision” document.

“We intend to marry our efforts next year,” Bordenick said.

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