In a HIMSS2017 forum with two former administrators of CMS, the most recent head of the agency, Andy Slavitt, drew both applause and surprised looks from the audience over his pointed criticism of the health IT industry.
Slavitt was asked about problems achieving interoperability. He lamented how primary care physicians won’t hear about care provided by a specialist they had recommended, a task he said was simpler to track compared to what the smartphone in the doctor’s pocket can do. Because it’s not making their work more efficient and easier, Slavitt said, “they hate it.”
“So they believe someone, somewhere, is purposely screwing things up, and I think they’re right,” Slavitt said to laughs from the audience.
Some of the blame for these frustrations, Slavitt said, falls on the agency, which he ran from March 2015 to January 2017 under President Barack Obama. He said CMS created regulatory hurdles for health IT rather than encouraging them to work with healthcare professionals to settle workflow issues. He said those burdens were reduced under his watch and now it’s up to vendors to develop better products with input from the people who will be using them.
First, Slavitt said, the industry has to stop “siloing data,” which he believed has been motivated purely by business reasons. Second, he said the industry has to stop producing IT solutions which are “still not doing what physicians and patients find useful and valuable.”
“That has to happen,” Slavitt said, “and that’s why I’ve been making comments like instead of going and spending $2 million on a booth at HIMSS, let’s wait to do that until we have a bunch of thrilled customers.”
The audience, many of them health IT professionals, applauded that slam on the industry.
Compared to Slavitt, former CMS Administrator and FDA Commissioner Mark McClellan was far less harsh in his critiques of vendors. He did say organizations which are solely focused on using IT to “hoard the data” or “maximize revenue or maximize billing” will be left behind in the transition to value-based care. But he also expressed that he feels the industry’s products are making real progress in that payment transition.
To close out the session, Slavitt did offer a path to fix the problem he sees in health IT: open application programming interfaces (APIs) to work across different platforms and pull and make use of data from existing EHRs. The companies which then develop technology which appeals to providers who don’t want an entirely new system will then be able to challenge more established IT vendors, according to Slavitt.
“Right now—and I’m going to sound like [President Donald] Trump for second—but it’s a bit of a failing industry,” Slavitt said, “because it’s not satisfying its customers.”