National Coordinator for Health IT Speaks to NAHC Board of Directors
June 26, 2013 09:03 AM
Earlier this month, the NAHC Board of Directors welcomed Dr. Farzad Mostashari, National Coordinator for Health Information Technology (IT) at the U.S. Department of Health and Human Services (HHS), to its meeting in Annapolis, MD. Dr. Mostashari was invited to speak to Board members about his vision for a 21st century health care system and the role that health IT can play in supporting home and community-based care models.
“It was a great honor to have Dr. Mostashari with us at our Board meeting,” said NAHC President, Val J. Halamandaris. “We look forward to working with him to make telehealth and health information technology more generally available to Medicare patients.”
During his remarks, Dr. Mostashari highlighted several emerging trends enabled by the Affordable Care Act (ACA), including an anticipated shift away from the current fee-for-service payment structure and toward value-based care models. He asked NAHC’s Board members to consider how long-term, post-acute care (LTPAC) providers can align with initiatives led by acute care facilities, including efforts to reduce Medicare readmission rates. He also suggested that home health and hospice providers should embrace the new care models currently being piloted by the Centers for Medicare & Medicaid Services (CMS), such as value-based purchasing and accountable care organizations (ACOs).
Additionally, Dr. Mostashari engaged in a robust dialogue with NAHC’s Board members regarding the need for improved quality measures in the home health and hospice care settings. He listened to concerns regarding the current lack of meaningful metrics in these care settings and acknowledged the need for quality measures that span the spectrum of care.
Dr. Mostashari’s remarks also focused on the adoption and “meaningful use” of electronic health records (EHRs) in LTPAC settings. Although home health agencies and hospice providers are not eligible for incentives under the Health Information Technology Economic and Clinical Health (HITECH) Act, Dr. Mostashari suggested that LTPAC providers can align with eligible professionals and hospitals by adopting systems that use the standards required in Stage 2 of the meaningful use program (effective on October 1, 2013 for eligible hospitals; January 1, 2014 for eligible professionals).
Some examples of these standards include:
Content– Stage 2 of the meaningful use program requires the patient care summary to be structured using the HL7 Clinical Document Architecture (CDA), Continuity of Care Document (CCD). Use of a consistent content standard is intended to facilitate health information exchange across a variety of care settings.
Vocabularies – Stage 2 also implements a set of consistent vocabulary standards for expressing key data elements in a patient’s health record, including problem lists (expressed using the SNOMED-CT standard), lab tests (expressed using the LOINC standard), and medications (expressed using the RxNORM standard).
Transport – Stage 2 of the meaningful use program requires EHR technology to be able to electronically receive transition of care/referral summaries using the ONC Applicability Statement for Secure Health Transport (also known as the “DIRECT” messaging standard).
Dr. Mostashari highlighted the impact that Stage 2 of the meaningful use program stands to have on a patient’s ability to view, download and transmit their own health information to a recipient of their choice. “Blue Button” initiatives currently underway at several federal agencies, including CMS and the Department of Veterans Affairs (VA), aim to create a simple, uniform mechanism for enabling a patient to access their own information. CMS currently makes a three-year longitudinal claims record available to each beneficiary and there are a number of industry applications that can transform this data into a simple, easy-to-use record at the point of care.
For additional information on Dr. Mostashari’s remarks or home health IT initiatives more broadly, please contact Richard D. Brennan, Jr. MA, Executive Director of NAHC’s affiliated Home Care Technology Association of America, at firstname.lastname@example.org.