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.
Karen DeSalvo, MD, the national coordinator for health information technology for HHS, is leaving her post to to address public health issues, including becoming a part of the Department’s team responding to Ebola. She took over as the ONC head in January, 2014.
The ONC’s COO Lisa Lewis will serve as the agency’s acting national coordinator.
HHS spokesman Peter Ashkenaz told THCB:
“HHS Secretary Burwell asked National Coordinator for Health IT Karen DeSalvo to serve as Acting Assistant Secretary for Health, effective immediately. In this role she will work with the Secretary on pressing public health issues, including becoming a part of the Department’s team responding to Ebola. Dr. DeSalvo has deep roots and a belief in public health and its critical value in assuring the health of everyone, not only in crisis, but every day.
Lisa Lewis, ONC’s chief operating officer, will serve as the Acting National Coordinator. However, Dr. DeSalvo will continue to support the work of ONC while she is at OASH.”
The transition 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.
We have some questions for you—questions, that is, about health information. What is it? Can you get it when you need it? What if your community needed important information to make your town or city safe or keep it healthy? How about information about your health care? Can your doctors and nurses get health care information about you or your family members when they need it quickly?
I came across a recent Wall Street Journal article about a remarkable story of health, resilience and survival in the face of an unimaginable health crisis—a Liberian community facing the advancing Ebola infections in their country got health information and used it to protect themselves. When the community first learned of the rapidly advancing Ebola cases coming toward them, the leaders in that Firestone company town in Liberia jumped on the Internet and performed a Google search for “Ebola”.
Making Sense of Blue Button, Meaningful Use, and What’s Going on in Washington …
At the recent Health 2.0 Conference in Santa Clara, co-chair Matt Holt expressed frustration about the difficulty of getting copies of his young daughter’s medical records. His experience catalyzed a heated discussion about individuals’ electronic access to their own health information. Many people are confused about or unaware of their legal rights, the policies that support those rights, and the potential implications of digital access to health data by individuals. The Health 2.0 conference crowd included 2000 entrepreneurs, consumer technology companies, patient advocates, and other potentially “disruptive” forces in healthcare, in addition to more traditional health system players.
Why is this topic so important? Until now, most people haven’t accessed their own health records, whether electronically or in paper, and I believe that making it easier to do so will help tip the scales toward more meaningful consumer/patient engagement in healthcare and in health. Access by individuals and their families to their own health records can empower them to coordinate care among multiple healthcare providers, find and address dangerous factual errors, and take advantage of a growing ecosystem of apps and tools for improving health-related behaviors, saving money on health services, and getting more convenient, personalized care.
A shorthand phrase for this kind of personal empowerment through access to digital health data is “Blue Button,” which is also the name of a public-private initiative in which hundreds of leading healthcare organizations across the US participate. The Blue Button Initiative is bolstered by the electronic access to health information requirements for patients in the “Meaningful Use” EHR Incentive Program, which is administered by CMS (the Centers for Medicare & Medicaid Services) with companion standards and certification requirements set by ONC (the Office of the National Coordinator for Health Information Technology).Continue reading…
Matthew Holt interviewed Jacob Reider, Deputy National Coordinator for Health Information Technology and Chief Medical Officer at the ONC, ahead of his appearance at the 8th Annual Health 2.0 Fall Conference. Jacob will be participating in several panels at Health 2.0, beginning with the Monday main stage panel “Smarter Care Delivery: Amplifying the Patient Voice”.
In this interview, Jacob gives an overview of the HITECH program, the question of interoperability, and the broad adoption of technology in health care as an industry.
Matthew Holt: So, let’s touch base on a couple of things. You’ve been in ONC some time now. Let’s talk about how the general HITECH program has gone and is going. If you were to get to rate it, the spread of EMRs and the usefulness of them, their usability, how would you say we’re doing so far?
Jacob Reider: I think we’re doing very well. Some of your readers know I went to college at a place that had no grades. So I’ll give you the narrative score.
The narrative score is that the program has been very successful achieving the goals that were defined at the outset. So the first iteration of the program, stage one, was all about getting organizations to adopt Health Information Technology, and I think all of the metrics that we’ve seen have validated that the program has been quite successful in accelerating the adoption of Health Information Technology, in both hospitals and practices. That doesn’t mean that we’re finished, but the vast majority of these organizations have now adopted Health Information Technology. Are there additional goals that we’d like to be able to meet? Absolutely, we’d like to see interoperability working better. As you mentioned, we would like the products to be more usable, and therefore, safer.
We’d like to see patients even more engaged than they currently are, so they have more access to the information in their records. We’d like to solve a problem that we’re starting to see in the industry, which I started to call hyperportalosis, which is that in any given community, there may be many portals that patients are expected to log in to. So we’re trying to think about how those problems can be solved in the next iteration of the HITECH program.
The question isn’t whether or not we will have another disaster – it is just a matter of when, where and how severe it will be. The recent earthquake in Northern California, centered near Napa, serves as a reminder that we must be prepared for the unexpected no matter where we live.
Northern California’s largest quake since 1989 happened in a large state where ONC has been working for the past year to ensure health data access every day and especially during disasters. In fact, in April of this year, we issued an assessment on available opportunities to address potential disasters in California and along the Gulf Coast.
Based on those assessments and our expectations of a catastrophic event in California, ONC started working with state emergency medical services officials last year to begin connecting the state’s 35 health information exchange organizations (HIEs) and EMS organizations. This effort was launched to help ensure health data access during emergencies.
The program is working on a pilot project involving several counties in California. However, the Northern California earthquake reminds us that there is much work to do, and it must happen faster statewide and nationwide. We simply cannot make assumptions about how best to prepare for emergencies. In recognition of the importance of this initiative, the HHS Idea Lab awarded a joint ONC/ASPR proposal for the inaugural HHS Ventures Program. The team has been actively engaged in this project as well as other ways technology can improve the routine delivery of care and disaster response – all in an effort to create more resilient communities.
This week a host of organizations responded to a Senate Finance Committee request for feedback on how to better use healthcare data.
The inquiry is timely, given the widespread frustration providers have with health information technology (HIT), and electronic health records (EHR) systems in particular. This frustration stems from many HIT/EHR systems are locked in proprietary systems. This hinders technology’s ability to connect and exchange information freely between disparate systems, devices and sensors along the care continuum, thus undermining the overall goal of using HIT to improve efficiencies and reduce costs.
An example illustrates the point. Because HIT systems don’t work together, most hospitals use nurses to manually double check input from disparate “smart” devices. For instance, an infusion pump reports the level of pain medication being administered to a patient, as does the EHR. But these numbers sometimes don’t match, and must be double checked by at least two nurses to confirm the right dosing. Not only is this a step back for efficiency, but it’s also another manual process that has the potential to create errors and patient safety issues.
There are also economic consequences of data fragmentation. According to the Office of the National Coordinator (ONC), U.S. providers are spending $8 billion a year due to the lack of interoperability.
To address this problem and reduce the unnecessary fragmentation of healthcare data, it’s time to require the use of open and secure applications programming interfaces (APIs).
In April, a group of America’s leading scientists, named JASON, published a report that found the current lack of interoperability among HIT data sources is a major impediment to the exchange of health information. They recommended that EHR vendors be required to develop and implement APIs that support health data architecture. The recommendation was also endorsed by the President’s Council of Advisors on Science and Technology (PCAST) in May. Requiring open APIs as a foundational standard for healthcare data would reverse the current legacy of locked systems and enable the real-time exchange of information in EHR systems to reduce costs and improve patient safety.
Heart disease and stroke are two of the leading causes of death in the United States. To combat these threats, the Department of Health and Human Services (co-led by Centers for Disease Control and Prevention [CDC] and the Centers for Medicare & Medicaid Services [CMS]) has joined with private and non-profit organizations such as the American Heart Association, American Pharmacists Association and the YMCA, to launch Million Hearts®, a national initiative to prevent one million heart attacks and strokes by 2017. The initiative is working to encourage clinicians nationwide to improve the quality of care through use of the ABCS strategies – Aspirin when appropriate,Blood pressure control, Cholesterol management and Smoking cessation.
On July 7th, as we marked the halfway point in this ambitious drive to improve America’s health, the Office of the National Coordinator for Health Information Technology (ONC), in collaboration with the CDC, launched the EHR Innovations for Improving Hypertension Challenge to accelerate improvement on the Million Hearts® “B” strategy – Blood Pressure Control. The goal is to show how professionals are using health IT to improve patients’ cardiovascular health. Evidence-based treatment protocols are an essential tool for providers to use in improving blood pressure control.
What makes this ONC challenge unique? First, it taps the expertise of clinicians who care for patients with hypertension and are using health IT to improve their control. Second, the challenge is designed to promote the scalability of critical tools for maximum impact and reach.Continue reading…
Federally funded health centers are making strides adopting and using electronic health records (EHRs) to treat some of the nation’s poorest and most at-risk patients since the enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act, according to a new first-of-its-kind study.
We know that health IT can help improve care quality. ONC and the Health Resources and Services Administration (HRSA) are working hard to ensure that all providers adopt and use EHRs. In the past, some researchers found that there might be a digital divide in health IT use, meaning that providers who mostly serve certain groups of people – particularly the poor and racial/ethnic minorities or people in rural areas – may be using health IT less than others.
Community health centers remain the largest provider of health care to underserved individuals in the US. They provide health care to more than 20 million Americans every year, including many who are poor, uninsured, or have no regular source of care.
In the past, health centers used health IT at a lower rate than other providers. In 2006, a survey showed that only 26% of health centers had any EHR capacity at all.
To ensure that the benefits of health IT and care transformation be available to all Americans, regardless of insurance, wealth, or location, the HITECH Act provided federal resources to help health centers adopt EHRs.
During National Minority Health Month, we acknowledge the potential for health information technology (health IT) – from electronic and personal health records to online communities to mobile applications – to transform health care and improve the health of racial and ethnic minorities.
Lack of access to quality, preventive health care, cultural and linguistic barriers, and limited patient-provider communication are factors that aggravate health disparities.
By increasing our investment in health IT policies and standards, we can help improve the quality of health care delivery and make it easier for patients and providers to communicate with each other – a huge step toward addressing the persistence of health disparities.
The Pew Research Center’s Internet & American Life Project found in 2012 that African Americans and Latinos are more likely to own a mobile phone than whites and outpace whites in mobile app use, using their phones for a wider range of activities.
The study showed that African Americans and Latinos use their mobile phones more often to look for health information online. This has very important implications for personal management of health and interaction with the health care system.
However, barriers to widespread adoption of health IT remain.
For example, a 2014 consumer engagement report found that minorities were less likely to adopt online patient portals to access their health information than were non-Hispanic whites.