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In April 2004, Executive Order 13335 (69 FR 24059) was issued by President George W. Bush. The order established the Office of the National Coordinator for Health Information Technology (ONC), which reports to the Secretary of HHS. It was established to “provide leadership for the development and nationwide implementation of an interoperable health information technology infrastructure to improve the quality and efficiency of health care.”
Acting at the speed of government, in 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act was created. According to The Washington Post, the HITECH Act included “as much as $36.5 billion in spending to create a nationwide network of electronic health records fulfilled one of Obama’s key campaign promises — to launch the reform of America’s costly health-care system.” Find out how our HIPAA compliant app cloud fits into this picture.
In July 2010, the government published 42 CFR and 45 CFR, outlining the EHR initial set of standards and EHR incentive program to drive EHR adoption.
To give focus to the EHR spending, the government enacted “meaningful use” (MU) criteria that sets specific objectives eligible professionals and hospitals must achieve to qualify for Centers for Medicare & Medicaid Services (CMS) incentive programs. According to HealthIT.gov Meaningful Use is using certified electronic health records (EHR) technology to:
The ultimate objectives of MU are to achieve better clinical outcomes, increased transparency and efficiency, to empower individuals, and to gain more robust research data.
Meaningful Use criteria were broken out into three stages that were to evolve over five years. Stage 1 was for the period of time from 2011 to 2012, where the MU criterion to be measured was the ability to capture and share data. It set the foundation for the EHR Incentive Programs by establishing requirements for the electronic capture of clinical data, including providing patients with electronic copies of health information. Stage 2, for execution in 2014, was focused on advancing the use of EHR in clinical processes. It encouraged the use of health IT for continuous quality improvement at the point of care and the exchange of information in the most structured format possible. Stage 3, which started this year (2016), is FINALLY focused on “improved patient outcomes”.
This effort directed EHR software providers to roll out capabilities in alignment with the stages of MU to enable eligible provider reimbursement under the incentive plan. It seems to me the stages were in the wrong order from the beginning. Shouldn’t it always have been focused on better patient outcomes to lower the cost of healthcare delivery and “improve quality, safety, and efficiency, and reduce health disparities”? Giving billions of our taxpayer dollars to capturing data instead of focusing on the true desired results (better patient outcomes and increased efficiency) seems backwards to me.
Today’s reality as a result of Stage 1 and Stage 2 MU incentives is that EHR systems are islands of inefficiency. They are great at capturing data and recording patient information, treatments, drugs, etc., but do little to improve outcomes. In fact, many physicians complain about the amount of time it takes to record patient information on classic PC screens that don’t fit into their daily workflows – some have even cutting back on the patient load so they have enough time to complete the required electronic paperwork.
Under the ACA, hospitals and primary physicians are being asked to transform their practices financially, technologically, and clinically to drive better health outcomes, lower costs, and improve accessibility to healthcare. With ACA, the healthcare market is shifting from pay for service to value-based pay for outcomes – a long time in coming.
With greater than more than 200 million Americans owning a smartphone, innovative healthcare providers and pharma companies are looking at how to expand patient involvement in their own care to improve outcomes and lowering the cost of ongoing care.
Mobile apps, wearables, and smart devices have the power to engage patients and providers to transform healthcare delivery – meeting the objectives of Executive Order 13335 and ACA combined. Those objectives include increased access to care, higher quality of services, greater affordability and the original goal, better outcomes for patients, providers, payers and pharma organizations.
The only problem is the EHR is still an island and the MU incentives should now be focused on bringing these two worlds together to combine all of the data captured in the EHR with new data types collected from patient surveys, activity monitors, health monitors, and other connected devices.
Following the money doesn’t always help you, but given this perfect storm, now is the time to bridge EHRs and digital health. It’s taken 12 years from the original Executive Order in 2004, but I’m excited about the role that the Progress Kinvey’s serverless cloud backend is playing in helping providers, pharma, and payers such as Thomas Jefferson University, Sanofi, and AMGEN accelerate this innovation to drive better outcomes for all. Learn all about the Progress Health Cloud.
Learn more here about Progress Health Cloud and how to build a HIPAA Complaint Application
Margaret is a results-oriented B2B marketing leader with experience in full stack marketing and a focus on delivering winning growth strategies for start-ups and Fortune 500 companies across mobile and new digital app experiences, PaaS, SaaS, hybrid cloud, IT infrastructure management and BI. Margaret is passionate about helping customers realize their digital business goals quickly.
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