Weekly roundup: Tavenner, HIE, Health IT

It was another busy week in the health IT arena but, I think the biggest news is the fact that Marilyn Tavenner was finally confirmed as head of the Centers for Medicare & Medicaid Services (CMS). This marks the first time CMS has an official leader since 2006. The general consensus at the confirmation vote was that a stable, secure leader is needed to shepherd the nation through all the upcoming efforts required by the Affordable Care Act.  

One of many challenges facing Tavenner is criticism that CMS has done little to prevent unsafe prescribing patterns for patients on Medicaid Part D, and to reduce questionable prescribing practices. An analysis by ProPublica, an independent newsroom that performs investigative journalism in the public interest, resulted in a new tool called Prescriber Checkup which allows the public to search providers by name.

The analysis revealed a widespread pattern of prescribing of drugs that are potentially harmful, disorienting or addictive for older Americans, determining that little has been done in the way of prevention. The data show that 1.1 billion claims were filed in 2010, with just 70 providers each responsible for more than 50,000 prescriptions and refills, which equals about 137 a day.

Meanwhile, the Office of the National Coordinator of Health IT (ONC) held a conference call about its health information exchange (HIE) governance framework. More than 1,000 registered callers listened in, indicating the high level of interest in the topic, said National Coordinator Farzad Mostashari, MD, ScM.

Progress on the HIE front serves to draw the challenges more sharply than ever before, he said. For example, “software developers are working very hard to implement interoperability standards to reduce cost and complexity [but] we need to improve the business case for information exchange so that it’s profitable to share information not hoard.”

Mostashari said the industry needs “mechanisms where the rules of the road, interoperability, privacy and business practices are standardized to the extent possible so that information can flow without the need for protracted, painful, expensive contract negotiations.”

Even as the global health IT market is estimated to jump 7 percent to hit $56.7 billion by 2017 from $40.4 billion in 2012, health IT adoption in medical practices remains problematic for many U.S. physicians, according to a Deloitte Center for Health Solutions survey.

Most physicians feel EHRs improve efficiency—in particular due to faster and more accurate billing and time savings through e-prescribing—and they also feel that non-adopters should be able to overcome cost and operational integration barriers to meet Meaningful Use (MU) Stage 1 requirements.

That being said, the survey found that nearly half of non-adopters have no plans in the works to adopt an EHR that meets MU criteria. The non-adopters “may be skeptical about clinical value and concerned about implementation costs,” according to the report. “As a result, care coordination via cross-practice clinical data sharing is not widespread. And the clinical impact of health IT on population health outcomes is not readily apparent in many communities.”

Do you have skeptical non-adopters? Please share your experience.

Beth Walsh

Clinical Innovation + Technology editor