Senate Finance Committee Examines Health Information Technology Progress
July 26, 2013 10:18 AM
The Senate Finance Committee recently held a set of hearings to examine progress made by federal health information technology (IT) initiatives since the passage of the Health Information Technology Economic and Clinical Health (HITECH) Act in 2009.
These hearings were conducted as a follow-up to an April 16 report on health IT released by GOP Senators Thune (SD), Alexander (TN), Roberts (KS), Burr (NC), Coburn (OK) and Enzi (WY). The report, “Reboot: Re-examining the Strategies Needed to Successfully Adopt Health IT,” suggested that a delay in implementation of the meaningful use program may be needed to assess whether it is on the right track.
Health IT: A Building Block to Quality Health Care
On July 17, the Committee held the first hearing in this series, “Health IT: A Building Block to Quality Health Care.” During this session, Committee members heard from the nation’s top health IT experts, Farzad Mostashari, National Coordinator for Health IT; and Patrick Conway, Chief Medical Officer and Director, Center for Clinical Standards and Quality, and Acting Director, Center for Medicare & Medicaid Innovation (CMMI) at the Centers for Medicare & Medicaid Services (CMS).
During their remarks, Mostashari and Conway highlighted several trends as signs of success. Mostashari pointed to the significant increase in adoption of electronic health records (EHRs) by providers and hospitals across the country, stressing that 40 percent of office-based physicians and 44 percent of hospitals have now adopted a basic EHR. Moreover, Conway emphasized that 190 million prescriptions have been sent electronically since the start of the EHR Incentive Programs.
Despite the progress that has been made, both officials acknowledged that there is still work to be done, citing lagging EHR adoption in small practices and critical access hospitals (CAHs), usability, practice workflow challenges, and the need for greater levels of interoperability across systems as key challenges. However, both Mostashari and Conway stated that Medicare readmission penalty policies and new payment and delivery models (e.g., bundled payments and accountable care organizations (ACOs)) have been effective in creating an emerging business case for information sharing.
When asked by Senator Hatch (R-UT) whether there is a need to delay either the rollout of Stage 2 of the meaningful use program or penalties for those eligible professionals and hospitals who do not meet program requirements within the allotted timeframe, Mostashari stated that such a delay would stall “hard fought” progress.
Health IT: Using It to Improve Care
A week later, on July 24, the Committee heard from a panel of private sector stakeholders during a hearing, “Health IT: Using It to Improve Care.” Witnesses included Janet Marchibroda, Director, Health Innovative Initiative, Bipartisan Policy Center; Dr. John Glaser, Chief Executive Officer, Health Services, Siemens Healthcare; Marty Fattig, Administrator and Chief Executive Officer, Nemaha County Hospital; and Dr. Colin Banas, Chief Medical Information Office and Associate Professor, Virginia Commonwealth University.
In general, all of the panelists expressed support for health IT, acknowledging that it serves as the foundation for many of the new payment and delivery models currently being tested by providers across the country. However, in contrast to the views expressed by Mostashari during the first hearing, several of the witnesses also voiced support for a delay in implementation of Stage 2 meaningful use requirements to give some providers (particularly those in rural areas) additional time to prepare for the advanced requirements.
In addition, there was general agreement about the need to go beyond implementation to incentivize the use of health IT to improve care. Each of the witnesses stressed that health IT implementation should not be merely a “check the box” activity, but should rather be geared toward making progress on outcomes-based quality measures designed to improve the health of patients and populations. Witnesses also echoed earlier statements by Mostashari and Conway, stressing the urgent need to make progress on interoperability.
New payment and delivery models rely on health IT to produce the right information at the right time. Despite ineligibility for the EHR Incentive Programs, home health and hospice providers should continue to align their IT systems with federal requirements. Careful consideration should be given to ensuring that systems support the seamless transition of care from acute facilities to long-term care and post-acute settings.
For additional information about health IT initiatives, please contact Rich Brennan at firstname.lastname@example.org.