Yesterday, the Governor's Healthcare IT Conference included remarks from Massachusetts HHS Secretary Bigby, Former National Coordinator David Blumenthal, Governor Deval Patrick, Special Assistant to the Administrator of CMS Sachin Jain, and a panel of industry experts.
Here are the key points.
Secretary Bigby introduced the meeting by noting the importance of healthcare IT for increasing safety, quality, efficiency, patient engagement, and equity in healthcare across the Commonwealth.
David Blumenthal summarized the accomplishments of ONC over the past two years and highlighted the work left to be done. He noted that the HITECH act and its meaningful use constructs are a "downpayment" on healthcare reform, creating the the necessary infrastructure over years to enable changes in healthcare delivery and reimbursement. The trajectory that we're on for meaningful use includes three stages: stage 1 which aligns incentives for providers to adopt and use EHRs, stage 2 which provides the standards and tools to exchange data and stage 3 which provides decision support tools and analytics. In each stage, privacy protection is a high priority. Breach notification requirements have been enhanced and penalties for breaches have been levied.
Thus far, 700 healthcare IT products have been certified, many by companies with less than 50 employees. 36,000 providers have registered to participate in incentive programs. $64 million has already been paid to 500 organizations as part of the Medicaid incentive program. On May 18 the Medicare incentive payments begin. 56 state designated health information exchanges have been created and 56 state HIE coordinators have been named. 62 Regional Extension Centers have been created which have enrolled 67,000 providers. About 25% of all primary care clinicians in the country now participate in regional extension center programs.
There has been a market change - Meaningful Use is becoming an emblem of quality. 80% of all hospitals intend to participate in stage 1 of Meaningful Use. The challenges ahead are many - we need additional standards, enhanced technology, and additional policy. However, the major change we need is cultural. Communities need to demand and encourage data sharing for care coordination, public health, and other uses.
Deval Patrick's remarks demonstrated significant domain expertise about healthcare IT and health information exchange. He highlighted Massachusetts' pivotal role as a leader in HIT product development, job creation, health information exchange, policymaking, and training. He encouraged all of us to break down data silos and create data liquidity - accelerating data exchange among payers, providers, and patients regardless of organizational boundaries.
Sachin Jain highlighted the importance of the CMS Center for Innovation noting that it empowers the CMS administrator to expand local demonstration projects to national scale if there is evidence they improve quality/reduce cost. The $1 billion dollar Partnership for Patients program is a part of the CMS Center for Innovation.
We closed the day with panel session of healthcare IT stakeholders
Alice Coombs, MD, President, Massachusetts Medical Society
Karen Bell, MD, MMS, Chair, Certification Commission for Health Information Technology
Lynn Nicholas, President, Massachusetts Hospital Association
Charlotte Yeh, MD, Chief Medical Officer, AARP Services
Alice highlighted the need for usability of EHRs such that clinician workflow is aided, not impeded by technology.
Karen discussed the need for clinicians to look beyond basic federal certification and think about clinical decision support features, data portability, security protections and vendor commitments to usability.
Lynn noted that CPOE and other technologies can introduce errors and adverse events. We need to ensure the technology is implemented wisely and clinicians are appropriately trained.
Charlotte represented the needs of consumers and suggested we embrace technology that brings demonstrated value to patients. As we think about PHRs, home care devices, and patient engagement, we must evolve from actions done "to the patient" to "for the patient" to "with the patient".
The bottom line - we should ensure our EHRs have the functionality we need to support safe, quality, efficient care with health information exchange, decision support, and security protections. We want these applications to be highly useable and integrated into workflows. We want them to incorporate policies that enhance the patient and provider experience.
I also made remarks about the need for additional standards that will be done to enable all these goals. I'll expand on our "Summer Camp of Standards" work next week.