How technology will shape healthcare

February 28, 2019
Todd Shryock
Todd Shryock

Todd Shryock, contributing author

ONC officials share their views on what the future of medicine should look like. 

At this year’s Health Information Management Systems Society conference in Orlando, more than 43,000 attendees saw the latest health technology and heard about how standards would better connect doctors and patients to the information they need.

But technology is still struggling to reduce the burden physicians bear when it comes to data reporting for prior authorizations, quality-measure reporting to the government, and accessing patient records in a timely manner. 

Reducing these burdens is a goal for John Fleming, MD, deputy assistant secretary for health technology reform at the Office of the National Coordinator for Health Information Technology (ONC). Fleming says he would like doctors to be able to focus on only the most important aspects of patient care with the rest being automated, similar to how the pilot of a modern aircraft only has to focus on takeoffs and landings. “Pilots sit in the cockpit and have access to the information they need and can do anything they need to with little effort or stress and no wasting of time,” says Fleming. He wants technology to assist doctors in real time, providing information on prior authorizations when the patient is in the exam room to eliminate the waiting and phone calls that can impact care. Patients should have all the information regarding appointments with specialists and all approvals, when they leave the primary care doctor’s office. “They should have everything they need and don’t have to call you back, not once,” he says.

Andrew Gettinger, MD, chief clinical officer for ONC, sees a technology-heavy future with artificial intelligence pulling information from different sources to help physician draw conclusions about care. “That’s probably not going to be possible in the software systems we have today,” Gettinger says. “They are really going to have to evolve.” He says in the near-term, there is an opportunity for technology to help remove the administrative burden physicians feel today. “If you ask doctors if they want to go back to paper, they say no, they just want the systems to work better. That’s what our goal is, and I think we are making substantial progress.”

ONC has been working on understanding and reducing the burdens associated with clinical documentation, prior authorizations, quality reporting, and prescribing, among others. As part of the 21st Century Cures Act, the Department of Health and Human Services (HHS) was tasked with developing a strategy and recommendations to reduce regulatory and administrative burdens. ONC and CMS, both part of HHS, have been working together to find solutions. 

“We’ve been very focused on that, and set up listening sessions to hear from practicing clinicians as well as other stakeholders in the healthcare continuum,” says Tom Mason, MD, chief medical officer for ONC. “The number one thing we heard was the clinical documentation of care delivery. Number two was prior authorizations, and we also heard that the lack of interoperability was a key area.”

Gettinger says that the request for comments on the proposed rule resulted in more than 1,200 pages of documents. The agencies are now in the process of evaluating the feedback and tweaking the proposed final rule. A report is expected to be issued to Congress in either late spring or early summer.

While this is certainly progress, ONC officials acknowledge that the pace of change will accelerate once industry standards are finalized and in widespread use by the healthcare industry. “For health IT, standards will help us move into being able to better leverage the technology to serve as a tool that will be helpful for patients as well as doctors,” says Mason. 

“If there is less burden, physicians are more productive, provide more dedicated care, and it improves access and it lowers costs,” says Fleming. “There’s a real value to this than just taking a headache away from doctors.”