Weekly roundup: Big week in Washington for health IT

This was a big week in the nation’s Capitol for health IT. Congress focused on mobile health, HIT policy and innovation.

The House Committee on Energy & Commerce held three days of hearings about health IT, focusing more specifically on whether medical apps are medical devices and therefore subject to FDA oversight and taxes.

Committee members shared their beliefs that mobile health apps offer great potential but they want to make sure patients’ safety isn’t at risk.

Witnesses called for a new patient-centric flexible framework to oversee health apps. “Health IT requires a different paradigm not well-suited to the current process,” said Jacqueline Mitus, MD, senior VP of clinical development and strategy for McKesson Health Solutions.

“It’s difficult to overstate our challenges,” said Joseph M. Smith, MD, PhD, chief medical and chief science officer at the West Health Institute in San Diego. “Our healthcare delivery system is exceeding our nation’s budget and our providers’ bandwidth without yet meeting our patients’ needs. Healthcare must be allowed and encouraged to rapidly evolve. We must drive regulation at the pace of innovation and not vice versa.”

During the March 14 Health IT Policy Committee meeting, Farzad Mostashari, MD, ScM, national coordinator of health IT, said, “Stage 3 rulemaking is not happening until next year. Let’s spend 2013 on implementation of Stage 2 capabilities. We need to learn from what’s working and what’s not working.”

Claudia Williams, director of the Office of the National Coordinator for Health IT (ONC) State HIE (Health Information Exchange) Program, discussed the state of exchange and the emerging technical, business and governance issues “that might create a roadmap of work” for the appropriate committees and ONC.

“There is a lot of exchange happening,” she said. Three of the biggest EHR vendors are each exchanging millions of patient records a month within and outside their own networks. Patient-mediated exchange will be a growing focus, she said. “People feel like we’re on a real tipping point in terms of not just patient engagement driven by payment reform but fundamentally a new world of data liquidity in which patients could really, in an automated way, have their medical information go from an EHR into a platform of their own choosing.”

Meanwhile, Richard Gilfillan, MD, director of the Center for Medicare and Medicaid Innovation (CMMI), told the Senate Finance Committee interim results from new payment and delivery models are forthcoming within a year with recommendations for payment and care changes to follow within two years.

The committee put Gilfillan and CMMI in the spotlight after a November 2012 U.S. General Accountability Office (GAO) report found, among other things, CMMI models potentially duplicative with other Centers for Medicare & Medicaid Services programs. CMMI was created in November 2010 pursuant to the Patient Protection and Affordable Care Act (PPACA) to test new models and delivery programs, including new incentive structures from fee-based to value-based care for more coordination, better outcomes and lower costs.

At the hearing, senators openly questioned the center’s $10 billion, 10-year budget during a time when sequestration is forcing agencies to scale back. Committee members broadly recognized the need for new, innovative ideas to lower cost and improve the quality of the U.S. healthcare system, but quizzed Gilfillan on progress made since the center launched.

As legislators reiterated again and again whether taxpayers are getting enough for their money, Gilfillan said, “We appreciate the resources we have and there is a great amount of work to be done. We are confident we’ll come back at some future time and be able to demonstrate that to you.”

Beth Walsh

Clinical Innovation + Technology editor