Report: HITECH course corrections needed immediately
"While efforts of the federal government, states and stakeholders to implement the HITECH Act are worthy of praise, there are course corrections that must currently be made to occur at both the legislative and regulatory levels," according to a report released by Manatt Health Solutions.
Prepared by Manatt Health Solutions and supported by the California HealthCare Foundation, Colorado Health Foundation, and the United Hospital Fund, the comprehensive report reviews HITECH and assesses the progress made to date as well as future challenges. According to the report, changes worthy of consideration are those designed to:
The report, based on interviews with 24 health IT experts, found that without a road map, the three-stage release of meaningful use criteria makes it difficult for healthcare providers to build achievable health IT strategies or to buy the most appropriate products. "Currently only stage-one standards have been released and the entire standard is not scheduled to be finished until about 2015," the report stated.
According to the report, eligible healthcare providers, especially small and rural practices, and certain community health centers, may have difficulty meeting the proposed "meaningful use" criteria, which may result in EHR adoption rates that are less than anticipated. "CMS should revise the proposed meaningful use criteria so they are more achievable and reflect the ability of current systems to support providers as they seek to integrate ambitious new EHR capabilities into their own clinical routines," the report recommended.
The report also found that the approach being proposed to allow different health IT systems to communicate with each other is unlikely to yield quality improvement and cost efficiency gains. Therefore, the report recommended that CMS ensure that the final meaningful use regulation includes provisions directly tying meaningful use to participation in HIE networks being developed under the State HIE Program.
The report also advises:
"HITECH is a necessary but not sufficient step to achieve greater quality and efficiency in healthcare," the report stated. "Building on the recently passed Affordable Care Act, additional policies should be developed, targeted especially toward Medicaid and the commercial health insurance markets, to encourage physicians and hospitals to organize into systems of care that deliver high performance through the use of health IT."
"The nation is at the beginning of an exciting journey that could lead to the dramatic transformation of the healthcare delivery and payment system," concluded the report. "Success will depend on the ability of everyone involved to learn from each other and to adapt and change policies and strategic direction to meet shared objectives."
Prepared by Manatt Health Solutions and supported by the California HealthCare Foundation, Colorado Health Foundation, and the United Hospital Fund, the comprehensive report reviews HITECH and assesses the progress made to date as well as future challenges. According to the report, changes worthy of consideration are those designed to:
- Ensure that the requirements and timing of meaningful use better reflect the existing capabilities of healthcare providers;
- Develop a coherent federal strategy to create an interoperable nationwide health information network; and
- Expand eligibility for EHR incentives to all providers.
The report, based on interviews with 24 health IT experts, found that without a road map, the three-stage release of meaningful use criteria makes it difficult for healthcare providers to build achievable health IT strategies or to buy the most appropriate products. "Currently only stage-one standards have been released and the entire standard is not scheduled to be finished until about 2015," the report stated.
According to the report, eligible healthcare providers, especially small and rural practices, and certain community health centers, may have difficulty meeting the proposed "meaningful use" criteria, which may result in EHR adoption rates that are less than anticipated. "CMS should revise the proposed meaningful use criteria so they are more achievable and reflect the ability of current systems to support providers as they seek to integrate ambitious new EHR capabilities into their own clinical routines," the report recommended.
The report also found that the approach being proposed to allow different health IT systems to communicate with each other is unlikely to yield quality improvement and cost efficiency gains. Therefore, the report recommended that CMS ensure that the final meaningful use regulation includes provisions directly tying meaningful use to participation in HIE networks being developed under the State HIE Program.
The report also advises:
- Stronger policies to encourage clinical practices to use evidence-based treatment guidelines consistently are necessary to ensure improvements in patient health outcomes.
- It is important to allow states to use meaningful use requirements as a policy lever to drive improvements in the care provided by Medicaid programs.
- To enable truly coordinated care across all settings, new legislation is needed to make currently excluded healthcare providers eligible for the Medicare and Medicaid EHR incentive programs or to authorize separate funding to support EHR adoption and ongoing use by such providers.
- Regional extension centers, created to assist provider organizations in meeting meaningful use requirements, may face sustainability and operational challenges, making it important to develop alternative approaches to ensure the provision of EHR adoption and implementation support services.
"HITECH is a necessary but not sufficient step to achieve greater quality and efficiency in healthcare," the report stated. "Building on the recently passed Affordable Care Act, additional policies should be developed, targeted especially toward Medicaid and the commercial health insurance markets, to encourage physicians and hospitals to organize into systems of care that deliver high performance through the use of health IT."
"The nation is at the beginning of an exciting journey that could lead to the dramatic transformation of the healthcare delivery and payment system," concluded the report. "Success will depend on the ability of everyone involved to learn from each other and to adapt and change policies and strategic direction to meet shared objectives."