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It’s Time for Bold Public and Private Sector Action on Health IT Interoperability

By Janet M. Marchibroda

Tuesday, December 15, 2015

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Public and private sector leaders agree on the urgent need to advance electronic information sharing and health information technology (IT) interoperability to support better health and higher quality, higher value care. Members of Congress, senior administration officials, and private sector leaders offered insights on how to achieve this goal during an event hosted by the Bipartisan Policy Center last week. BPC also released a new issue brief which highlights the current status of information sharing and interoperability and emphasizes why both are important in supporting the information needs of patients, rapidly emerging new models of delivery and payment, and advances in biomedical innovation.

Major Takeaways

Federal officials and private sector stakeholders agree that the lack of information sharing and interoperability is a problem that they must work together to solve. They also agree on many of the key steps that should be taken, including continued incentives for high-quality, coordinated, value-based care; adherence to business practices that discourage information blocking; adoption of a common set of standards; and performance transparency to inform users. They do not always agree on how to achieve these goals or the extent to which the responsibility should fall on the public versus private sectors. There are also questions about the need for a common trust framework. At the event:

  • Karen DeSalvo, national coordinator and acting assistant secretary for health at the U.S. Department of Health and Human Services, called on government and the private sector to work together to (1) assure consumers have ready access to and are able to share their health information, (2) put an end to information blocking, and (3) agree upon and adopt a common set of federally recognized standards. She also shared ONC’s goal to connect the health information exchanges—including the private sector exchanges—and catalyze the development of new apps to support information sharing within the coming year.
  • Andy Slavitt, acting administrator at the Centers for Medicare and Medicaid Services, emphasized that business practices—not technology—were the primary barrier to interoperability and encouraged private sector organizations to change their business practices to respect the information needs of the patient. Slavitt also described the federal government’s role in providing incentives for information sharing, referencing its specific goals for improving Medicare payments based on value and quality outcomes by 2018.
  • Senators Bill Cassidy (R-LA) and Sheldon Whitehouse (D-RI) highlighted the need for greater usability associated with information sharing and transparency, and discussed their Transparent Ratings on Usability and Security to Transform Information Technology (TRUST-IT) Act (S. 2141), which would establish a publicly available rating system that would allow users to evaluate electronic health record product performance on interoperability, security, and usability.
  • During the panel discussion: Jeff Allen, executive director of the Friends of Cancer Research, described the electronic information needs of cancer patients who often see multiple providers, and the importance of federal government guideposts and incentives. Dr. Mike Schatzlein, senior vice president and group operating executive at Ascension Health, shared progress made by large health systems and industry on advancing definition and adoption of standards to support interoperability between clinical software and medical devices. Dr. Steven Weinberger, chief executive officer of the American College of Physicians, called for greater inclusion of the physician voice in the policy dialogue related to interoperability and electronic information sharing. Finally, when asked about the appropriate role of government, Arien Malec, vice president at Relay Health, a McKesson Corporation company, emphasized the important role that the government plays as a purchaser of health care, and in both defining a vision for person-centered interoperability and a timetable for getting there.

As Congress and the administration consider next steps, the following questions are raised: What actions will the private sector take together to significantly advance achievement of these goals? Many forward-thinking providers, payers, and technology companies are beginning to embrace these challenges but to date there has not been industry-wide agreement on and adoption of common business practices and standards. What is the role of government and where is intervention needed? Government action often takes place when the market fails to act and consumers are at risk. How long will patients have to wait to be able to efficiently access and use their own health information, or have their clinicians do the same?

Answers to these questions are urgently needed to ensure that Americans are able to fully trust and realize the promise of health IT and the benefits of the investments that have already been made by the public and private sectors. BPC will continue to both monitor and highlight public and private sector actions in this area, and push for positive change.