2014 National Health IT Week Has Huge Impact

The week of Sept. 15-19 was the ninth annual National Health IT Week and quite a few stakeholders made their mark on the recognition week.

The Office of the National Coordinator for Health IT (ONC) held its fourth annual Consumer Health IT Summit, the Health Information Management and Systems Society (HIMSS) took its three “Congressional Asks” to Capitol Hill, legislators introduced the Flex-IT Act to counteract the Meaningful Use final rule and more.

The week began nine years ago with just six organizations holding events in six different cities, says Tom Leary, HIMSS’ vice president of government relations. This year, there were 440 partner organizations involved so “clearly, the idea has taken root that National Health IT Week is a great time to focus on the many aspects of health IT that can help advance healthcare transformation.”

Over the years, health IT has garnered “a great number of champions on Capitol Hill.” In fact, Leary says that engaging legislators several years ago resulted in the HITECH Act and Meaningful Use. “As a result, more and more legislators are paying attention and the expectations for how health IT can support healthcare transformation have risen each year.”

Another message this year was the role health IT plays supporting the economy with additional jobs and export opportunities, Leary says, a message that “resonated with legislators.”

HIMSS held interoperability and technology showcases and a value suite demonstrated the progress health IT is making on information exchange and, therefore, care coordination, Leary says. “The value of health IT was one theme and we got some great traction. It helped answer questions legislators have.”

Meaningful consumer engagement

During the Consumer Health IT Summit, Karen DeSalvo, MD, MPH, MSc, national coordinator of health IT, said she remains “firmly committed and optimistic about the opportunities for the ONC and our federal partners, as well as the private sector, to support consumer engagement in a meaningful way.”

She said she aims for not just sharing of information but “truly empowering” consumers when it comes to their health and healthcare.

DeSalvo noted the lack of interoperability in health IT systems which results in gaps, missed handoffs, unnecessary inconvenience and, in some cases, might even cause harm. “Consumers can help us play an increasing role in interoperability. The harnessing of health IT is going to transform the healthcare system into one that meets the needs and expectations of everybody in this country.”

The amount of information is increasing and going beyond what’s in EHRs, she says, and “advancing interoperability is really the means to the end.” That is, it is a way to ensure that an individual’s health information is accessible when and where it’s needed.  

The day’s and week’s events offered the chance for “robust discussion about the challenges and opportunities associated with incorporating these data. “Just because there are challenges doesn’t mean we should stop. It’s not just a good idea. It really matters. Digitization can democratize and empower us in a way we have never been able to do before.”

Fighting back on MU timeline

Several professional associations banded together to call for immediate action to amend the 2015 EHR reporting period.

In a letter to Dept. of Health & Human Services (HHS) Secretary Sylvia M. Burwell, the College of Healthcare Information Management Executives (CHIME), the Association of Medical Directors of Information Systems (AMDIS) and 15 other healthcare organizations issued an immediate call to action to adjust the 2015 EHR reporting period to help hundreds of thousands of providers meet Meaningful Use (MU) Stage 2 requirements safely and effectively.

Responding to the Centers for Medicare & Medicaid Services’ Aug. 29 final rule on MU flexibility, the letter states the agency’s decision to require a full-year of reporting using 2014 Edition certified EHR technology (CEHRT) in 2015 “puts many eligible hospitals and physicians at risk of not meeting MU next year and hinders the forward trajectory of the program,” the groups said.

By adjusting the timeline, providers would have the option to choose any three-month quarter for an EHR reporting period in 2015 to qualify for MU. 

Meanwhile, Congresswoman Renee Ellmers (R-N.C.) and Congressman Jim Matheson (D-Utah) introduced the Flexibility in Health IT Reporting (Flex-IT) Act which would grant the nation’s healthcare providers the additional flexibility in meeting MU requirements through a shortened reporting period in 2015.

The legislation, also in response to the Aug. 29 final rule, would allow providers to report their health IT upgrades in 2015 through a 90-day reporting period as opposed to a full year as the final rule calls for. An adjustment of the reporting timeline would allow providers to choose any three-month quarter in 2015, offering additional time and flexibility.

CHIME is one organization that offered support for the Flex-IT Act. “The misstep by officials to require a full year of reporting using 2014 Edition CEHRT in 2015 puts many eligible hospitals and physicians at risk of not meeting Meaningful Use next year and hinders the intended impact of the program,” said Russell P. Branzell, CHCIO, president and CEO. “To date, only 143 hospitals have met Stage 2, representing a very small percentage of the 3,800 hospitals required to be Stage 2-ready within the next 14 days.”

Progress on interoperability

During an ONC webinar, the agency shared the key components of its 10-year interoperability vision and its progress in establishing the “rules of the road” to further exchange. 

The 10-year interoperability vision ultimately fulfills ONC’s statutory purpose under the HITECH Act: “to establish a governance mechanism for the nationwide health information network,” said Jodi Daniel, JD, MPH, director of ONC’s Office of Policy Planning. 

During the past two years, ONC has entered into two cooperative agreements with existing HIE governance entities—DirectTrust.org and New York eHealth Collaborative—to work on a framework and principles of exchange. This effort, which dovetailed work to prepare for MU Stage 2, enabled the agency to develop a governance framework that hinges on four pillars: organizational, trust, business and technical.

“This was a key piece in driving some of the other work,” particularly the national HIE governance forum, which involved HIE governing entities identifying their common challenges and potential solutions, she said.

When the January roadmap comes out, “Give us feedback and tell us what you think,” Daniel said. “We’ll be incorporating your input into our thinking and into our final roadmap.”

Framework addresses EHR usability

In other developments, the American Medical Association (AMA) called for solutions to EHR systems that have neglected usability as a necessary feature, releasing a framework that outlines eight priorities for improving EHR usability.

“Physician experiences documented by the AMA and RAND demonstrate that most electronic health record systems fail to support efficient and effective clinical work,” said AMA President-elect Steven J. Stack, MD. “This has resulted in physicians feeling increasingly demoralized by technology that interferes with their ability to provide first-rate medical care to their patients.”

AMA’s framework stems from RAND’s study that confirmed the toll EHR dissatisfaction is taking on physicians. While AMA/RAND findings show physicians generally don’t want to return to paper-record keeping, physicians are justly concerned that cumbersome EHR technology requires too much time-consuming data entry, leaving less time for patients.

The recognition week will hit 10 years in 2015 so expect even more activity next year, says Leary. He’s already hoping for at least 500 partners. “We’re excited about the results of this year and are looking forward to next year.”