D.C. bipartisan center issues recommendations for health IT initiatives

While IT has been leveraged by other industries to lower costs and increase efficiency, the promise of health IT to transform the healthcare industry has yet to be realized even though millions of dollars in funding has been directed toward promoting health IT adoption, according to a Bipartisan Policy Center report. Based on the findings of a task force headed by former senators Tom Daschle (D-S.D.) and Bill Frist (R-Tenn.), the report makes six recommendations for accelerating the use of health IT.

The Bipartisan Policy Center, a nonprofit think tank based in Washington, D.C., formed the health project task force to identify the best practices for healthcare organizations to follow to facilitate coordinated, patient-centered care and to make recommendations for ensuring the optimal use of health IT.

The task force spent six months reviewing healthcare literature, interviewing healthcare professionals from nearly 40 high-performing healthcare organizations and identified six barriers to the optimal use of health IT: misaligned incentives, lack of health information exchange (HIE), limited level of consumer engagement with health IT tools, limited levels of EHR adoption, privacy and security concerns and vague federal priorities.

The report, published in January, offers a potential remedy for each of those barriers.

Align incentives
Because payment for medical procedures is currently based primarily on volume, there is little incentive for healthcare organizations to implement more efficient delivery models and the health IT systems needed to support them.

The report’s recommendations for aligning incentives are:

• Payors, whether public or private, should develop payment models that reward higher quality, more cost-effective care associated with health-IT enabled delivery models;
• Congress should consider ways it can encourage the implementation of patient-centered delivery models when it acts to replace the sustainable growth rate;
• State and federal governments, as well as the private sector should continue and expand pilot programs that test the effectiveness of patient-centered delivery models; and
• Members of the public and private sectors should collaborate more frequently to advance progress across the healthcare system in a more timely fashion.

Health information exchange
Patient-centered delivery models that rely on health IT tools require robust, interoperable HIE, which the Bipartisan Policy Center’s task force determined was generally unavailable.

The report’s recommendations for remedying the lack of HIE are:

• HIE operators should create a business case for their product by providing more services that allow providers to meet meaningful use incentive requirements;
• The federal government, with input from states and the private sector, should develop long-term strategies aligned with its public health agenda for interoperability;
• The federal government should facilitate a healthcare community-wide dialogue to determine a common set of principles, policies and standards;
• HIE operators and governments should more readily consider and seek out the opinions of patients and clinicians on HIE; and
• The federal government should build awareness of and promote its efforts to build robust, interoperable HIE.

Consumer engagement
Well-coordinated, patient-centered care requires involved, empowered patients, but effective health IT tools exist for personal use and those that do are not widely used.

The report’s recommendations for improving consumer engagement are:

• The public and private sectors should conduct outreach, electronically and otherwise, to demonstrate how health IT tools can help consumers manage their health and communicate with providers;
• Healthcare organizations should educate providers about the benefits of involved, empowered patients and about the health IT tools that are available for their use;
• The public and private sectors should continue to research consumer health IT tools, to encourage their development and to raise awareness, especially among low-income populations, of their existence; and
• Payors, whether public or private, should develop payment incentives that encourage healthcare organizations to incorporate consumer health IT tools into their practices.

EHR adoption
Although EHRs are necessary to use other health IT tools, barriers to EHR adoption, especially cost, still exist and adoption remains low.

The report’s recommendations for improving EHR adoption are:

• State and federal governments, as well as the private sector, should create and execute a strategy for raising awareness of the meaningful use incentives that can be achieved with an EHR system;
• The federal government should clarify meaningful use incentive requirements so that they are better understood by private sector providers;
• The federal government should make available to the public the information on best practices, which is currently only available to federal contractors and grantees, that  has been compiled by multiple federally funded programs;
• The public sector should create and execute strategies for sharing literature on best practices with providers and patients; and
• The healthcare community should collaborate to identify common problems with EHRs and demand that vendors address them.

Privacy and Security
The promise of health IT cannot be realized until all stakeholders are satisfied that data can be kept confidential and secure, but many don’t trust that health IT systems can do that.

To calm privacy and security concerns, the task force’s recommendations are:

• Require each entity that accesses or transmits health data to comply with HIPAA, or a set of standards that is equally or more comprehensive;

• The federal government should regularly issue guidance on complying with privacy and security laws;
• The federal government, in collaboration with other stakeholders, should develop and implement a strategy for improving the rates of accuracy in matching patients to their health information; and
• The federal government should develop a set of “common-sense” security practices and distribute it to providers.

Align federal programs
There are currently multiple federal initiatives encouraging providers to adopt health IT, but they are not streamlined and providers may not know what is being requested of them.

To sync federal program’s with one another, the report recommends that the federal government should:

• Begin developing immediately a set of action steps to align policies, programs and requirements;
• Develop a set of performance measurements to  gauge healthcare organizations’ improvement and to determine incentive payments;
• Align its programs with preferred delivery models rather than the ones currently in place;
• Continue to refine existing policies; and
• Spearhead efforts to increase the use of health IT tools for population health purposes.

The report is available in its entirety here.