This post is adapted from DeSalvo’s talk at the annual meeting of the Health and Information Management Systems Society in Chicago last week.
I am optimistic about the bright future we have to leverage health information technology to enable better health for everyone in this country.
One year ago, we called upon the health IT community to move beyond adoption and focus on interoperability, on unlocking the data, so it can be put to the many important uses demanded by consumers, doctors, hospitals, payers, and others who are part of the learning health system.
ONC spent the year listening to the health IT community to understand the challenges and opportunities and developing strategic roadmaps to guide our way. Our goal was to evolve to be best able to lead where appropriate, and partner wherever possible, as we all shift the national strategic focus towards interoperability. I hope you all have felt that shift.
Health primarily happens outside the doctor’s office—playing out in the arenas where we live, learn, work and play. In fact, a minority of our overall health is the result of the health care we receive. If we’re to have an accurate picture of health, we need more than what is currently captured in the electronic health record.
That’s why the U.S. Department of Health and Human Services (HHS) asked the distinguished JASON group to bring its considerable analytical power to bear on this problem: how to create a health information system that focuses on the health of individuals, not just the care they receive. JASON is an independent group of scientists and academics that has been advising the Federal government on matters of science and technology for over 50 years.
Why is it important to pursue this ambitious goal? There has been an explosion of data that could help with all kinds of decisions about health. Right now, though, we do not have the capability to capture and share that data with those who make decisions that impact health—including individuals, health care providers and communities.
The new report, called Data for Individual Health, builds upon the 2013 JASON report, A Robust Health Data Infrastructure. It lays outrecommendations for an infrastructure that could not only achieve interoperability among electronic health records (EHRs), but could also integrate data from all walks of life—including data from personal health devices, patient collaborative networks, social media, environmental and demographic data and genomic and other “omics” data.
HHS Clarification: DeSalvo Will Retain Leadership of ONC
Five days after announcing that National Coordinator Karen DeSalvo’s appointment as Acting Assistant Secretary of Health, the ONC clarified that DeSalvo would still be the leader of the ONC; she would also continue to chair the HIT Policy Committee, lead the development and finalization of the Interoperability Roadmap, and remain involved in MU policymaking.
HHS said that when DeSalvo’s new appointment was originally announced, DeSalvo’s bio had mistakenly indicated that she had “previously” held the role of National Coordinator.
HIT NEWSER’S TAKE: Did HHS simply do a poor job communicating or did someone recognize a little too late that DeSalvo’s removal might heighten concerns about the ongoing turnover among ONC leadership?
No More CCHIT
The Certification Commission for Health Information Technology (CCHIT) announced it was shutting down its operations November 14. CCHIT was created in 2004 to provide certification services for HIT products and to educate providers and IT developers; in January CCHIT announced it would no longer provide testing and certification services for the MU program. In a press release CCHIT Executive Director Alisa Ray said that “the slowing of the pace of ONC 2014 Edition certification and the unreliable timing of future federal health IT program requirements made program and business planning for new services uncertain.”
HIT NEWSER’S TAKE: Coupled with the recent turmoil at the ONC (leadership changes, underwhelming Stage 2 MU attestations numbers), one can’t help but wonder what it all means for long-term viability of the MU program and whether the industry remains committed to its objectives.
Amidst recent criticism that ACOs are failing to control costs, HHS announces an $840 million initiative designed to improve patient care and lower costs. The Transforming Clinical Practice Initiative will provide 150,000 clinicians with incentives and tools to “encourage doctors to team with their peers and others to move from volume-driven systems to value-based, patient-centered, and coordinated health care services.” Sounds a lot like the goal for ACOs, which HHS hoped would help providers to “work together to provide higher-quality coordinated care to their patients, while helping to slow health care cost growth.”
DeSalvo and Reider exit the ONC
Karen DeSalvo, MD, the national coordinator for health information technology for HHS, steps down from her post just 10 months into her job to assume the role of Acting Assistant Secretary of Health to address “pressing public health issues,” including the Ebola outbreak. The same day Deputy National Coordinator Jacob Reider, MD announced that he would also leave the ONC at the end of November. The ONC’s COO Lisa Lewis will serve as Acting National Coordinator. The changes comes at a time when critics are asking tough questions about the government’s Meaningful Use program and providers’ lackluster progress qualifying for Stage 2.
Epic, Ebola, and (legal) Payola
Epic President Carl Dvorak stands behind his company’s EMR and blames Texas Health Presbyterian clinicians for the mishandling of the country’s first Ebola patient. Meanwhile, the health system’s Chief Clinical Officer Daniel Varga, MD tells a Congressional committee that his organization is “deeply sorry” for “mistakes.” In unrelated Epic news, the company discloses it spent $24,000 over the last two months lobbying Congress. Epic is in the running for the Pentagon’s $11 billion EMR contract and fighting criticisms that its platform lacks interoperability.