Mostashari: 'Coordinated strategy required to accelerate HIE'

The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) presented their strategy to accelerate health information exchange during an Aug. 7 webinar.

The agencies issued a request for information (RFI) in March, the results of which played a big part of the strategy going forward, they said.

Health IT “intermediates, enables and supports better capabilities” for population health management, care coordination and patient empowerment, said Farzad Mostashari, MD, ScM, national coordinator of health IT. “We recognize that this doesn’t take place within a vacuum. How the tools are used are critically related to how care is paid for and incentives for healthcare providers.”

This ties into the collaboration between agencies are necessary to aggressively move forward, he said. ONC and CMS already are moving care payment away from volume toward value, he said. Despite the efforts made regarding accountable care, bundled payments and health homes, “we recognize it is not enough,” said Mostashari. “We want to signal clearly our commitment to the concept that patients’ information should flow wherever the patient goes. Coordination should be rewarded. We wish to communicate as clearly as possible that we intend to develop and implement a set of policies and programs that encourage providers to routinely exchange health information through an interoperable system in support of care coordination across healthcare settings.”

The RFI was designed to get ONC and CMS staff “smarter,” he said. It asked for input on policies and practices that can strengthen the business case for HIE. The RFI also signals that the agencies recognize that the incentive programs are necessary but not sufficient to achieve widespread HIE. “The goal of the RFI is to have you inform our policies and programs and to really spark action quickly as delivery and payment reform is depending on this capability being present.”

Suggestions to drive HIE included use of payment models, involving providers such as long-term care and behavioral health and voluntary health IT certification. “We can’t rely on any one tool to achieve our goals. We need a coordinated strategy to accelerate exchange across the healthcare system. There is no one-size-fits-all for how information is going to be exchanged.”

CMS also is working to align the Meaningful Use program with other reporting programs so that hospitals and physicians only have to report to CMS once, according to CMS Chief Medical Officer Patrick Conway, who also is the acting director of the Center for Medicare and Medicaid Innovation.

ONC and CMS received more than 200 comments on the RFI, which had been published March 7.

Mostashari said there is a lot of confusion about HIE and interoperability, and reiterated that there is a road map for information to be exchanged and used, but that there needed to be a better way to communicate it. He also said stakeholders need to educate themselves on what is happening and “we need to do a better job of creating easy to understand resources. Part of why we’re here is because this is complicated. But, we are making progress.”

ONC released a white paper outlining the RFI suggestions and strategy and the slide presentation of the webinar also is available.