In the face of growing criticism and impatience with the Meaningful Use EHR incentive program, National Health IT Coordinator Dr. Karen DeSalvo remains upbeat but aware of the tough work ahead to achieve the vision of a learning health system underpinned by a network of interoperable EHRs.
“Interoperability is a priority, but it is still just a means to an end,” De Salvo said Thursday morning in a keynote session on the last day of HIMSS15 at McCormick Place in Chicago. Without interoperability, it will be difficult to achieve healthcare payment and delivery reform, she added.
Congress in particular has been grilling ONC and its supervisors at HHS over the lack of perceived value returned for the $29 billion spent on Meaningful Use incentives to date, even though the real returns on investment were not supposed to appear until Stage 3, which begins no earlier than 2017. DeSalvo all but brushed off the pressure.
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“Congress is our partner and am so excited that they share an interest” in getting health IT to improve healthcare, she said. “It’s been a good dialog.”
DeSalvo noted that it has been just six years since the Health Information Technology for Economic and Clinical Health (HITECH) Act became law and four since Meaningful Use started. “Look at the progress,” she said.
However, the job is far from done. “The glass is indeed half full, but when you step back, you see it is still a small glass,” DeSalvo said.
She touted some of her office’s recent accomplishments, including the publication of the Federal Health IT Strategic Plan and accompanying road map to interoperability, an effort she said was to “refresh strategic direction” of health IT across the government. “The world has evolved since our last strategic plan five years ago,” DeSalvo said.
ONC last week also issued a scathing report about “information blocking” by certain, unnamed vendors. Acting Centers for Medicare and Medicaid Administrator Andy Slavitt, who shared the HIMSS stage with DeSalvo, said he wanted to hear from healthcare providers about “every incident of information blocking, no matter how small” to help weed out the problem.
Slavitt, who came to Washington in late 2013 to help turn around the Healthcare.gov insurance marketplace after a failed public launch, talked about his desire for useful IT in healthcare, particularly “infrastructure” like EHRs and data-sharing networks.
“We have a great need for a more modern infrastructure for healthcare,” Slavitt said. “We need a Moore’s Law effect in healthcare productivity” to care for multiple chronics and aging baby boomers. “Aging technology is actually weighing us down,” Slavitt added.
He took a dig at the large amount of private investment flowing into consumer-facing digital health. “I think we could do a little less innovation in shareable and wearable” and more focus on infrastructure, Slavitt said, to help support new, value-based payment models.
Slavitt admitted that CMS needs to become more responsive to provider needs. The January announcement that would acceleration the shift to value-based payment was a step in this direction. “We hope this will provide the industry with more clarity and more certainty,” Slavitt said.
He added that CMS needs to do all it can to simplify regulations.
DeSalvo used a sports analogy to express her optimism that there is light at the end of the long tunnel, as long as the health IT and healthcare communities are willing to continue their work. “It’s the fourth quarter, and games are won and lost in the fourth quarter. We cannot, should not do it alone,” the ONC boss said.
