The Trump administration recently released the much-anticipated proposed rules designed to facilitate interoperability among healthcare systems and stem the harmful practice of information blocking, which occurs when vendors or providers willfully impede the flow of health information.
It was a long time coming. The Health Innovation Alliance (formerly Health IT Now), where I am privileged to serve as executive director, first made the Office of the National Coordinator for Health Information Technology (ONC) aware of these problems plaguing the healthcare system in 2011.
From there, we led the effort to secure inclusion of tough language in the 21st Century Cures law to end information blocking (Section 4004).
While a step in the right direction, the administration’s proposed rules are a reminder that the federal government’s treatment of health IT remains underwhelming.
After all, these proposals are a years-delayed response to the challenges of today. Such reactive, better-late-than-never policymaking leaves scant room for laws and regulations that anticipate the technologies of tomorrow, or that challenge our healthcare system to live up to its fullest potential.
Today, the healthcare marketplace is ripe with disruptors who are ready to lead us into the future, but we’re asking them to shoehorn these ideas into a fragmented system that is stuck in the past.
EHRs are nearly ubiquitous but instead of transforming care, they’re de-personalizing it; consuming nearly 40 percent of doctors’ time meant for patients.
We’ve witnessed the vast potential of telehealth, but traditional Medicare spends less than one percent of its budget on such services.
We talk ourselves in circles about interoperability and, still, only 4 in 10 hospitals can send, receive, find, and integrate information the way consumers expect of other industries.
It’s time to go bigger on health IT policy.
At the Health Innovation Alliance we are assuming this task in several new areas, including: modernizing patient privacy laws to keep pace with the information age; leading the charge to expand the role of technology and data in value-based care; and reimagining a healthcare system that is build around the patient, rather than the care setting.
Modernizing patient privacy laws
To start, the Health Insurance Portability and Accountability Act (HIPAA)—the privacy law governing patients’ medical records—was enacted more than 20 years ago and is showing its age. Today, HIPAA can be a backdoor means of information blocking. It relegates patients to reams of paperwork for simple requests, acts as a barrier to care coordination, and lacks meaningful enforcement. It was built for the era of the fax machine, not the iPad.
In the year 2019, no patient should be forced to accept a false choice between privacy and seamless access to their healthcare information. Both are possible and necessary, and we will use the full power of our coalition to fight for a modernized HIPAA that provides exactly that.
Expanding the role of technology in value-based care
Further, our newly relaunched organization will lead a conversation on the role of data and technology in accelerating the system-wide march towards value-based care. This discussion should include a major focus on emerging companies and technologies, such as artificial intelligence, data, and the role both can play in augmenting value.
The Health Innovation Alliance will champion measures such as enacting new incentives allowing hospitals to donate technology to clinicians in their community for value-based programs without running afoul of fraud laws.
If we are to have a robust, value-based system in healthcare that rewards positive health outcomes, we need the technology in place to measure these outcomes effectively. Federal laws should help – not hinder – the process.
Re-centering healthcare around the patient, not the care setting
We must also tackle obstacles that leave patients saddled with a healthcare system built around the care setting, instead of the individual.
For example, licensing barriers and Medicare originating site requirements too often limit the use of telehealth to those in designated rural areas, when every patient should have access to virtual care.
Our members will work to secure reimbursement of care delivered via digital networks of peer supporters. Americans spend an average of 11 hours a day looking at a screen, so let’s put it to good use by allowing patients to receive safe, confidential counsel through these same tools. We should see to it that federal health programs recognize social media platforms as viable settings where patients can connect with a peer-support program or discuss their treatment with a physician.
These efforts will be part of a broader strategy to ensure that patients receive care on their own terms, at the best available cost, and by the most appropriate healthcare practitioner, irrespective of geographic boundaries.
Health Innovation Alliance will use the former to change the latter. We will go beyond “meaningful use” to total transformation.
Our members have a vision for a modernized, 21st century healthcare landscape in which technology and data are used to deliver meaningful value, allow for the seamless exchange of healthcare data, and keep consumers at the center of their care.
Now, we are putting that vision into action.