From my perspective, health information technology today serves as a primary catalyst and strategic asset for change benefiting patients, especially in three vital areas—payment reform, technology interoperability and telehealth.
Health IT plays a vital role in payment reform, which involves transitioning from fee-for-service to value-based payments made according to patient health outcomes. Interoperable health IT enables providers and patients to seamlessly share and use health information between physician practices, hospitals and health systems, and across regional borders, so that decisions in the best interests of patients can be made at the point of care quickly and without the need for duplicate tests and procedures. Telehealth allows patients and providers to virtually engage online, via telephone and other technologies when time or distance make in-person appointments impractical.
A number of payment reforms are being rolled out through the Medicare Access and CHIP Reauthorization Act, also known as MACRA; the Merit-Based Incentive Payment System, or MIPS; and alternate payment models. The CMS and the Office of the National Coordinator for Health Information Technology have developed guiding principles on how the meaningful use program will fit with MACRA implementation. To succeed under new payment models, providers will require user-friendly IT tools and strategies to document value.
The goal of communicating these principles is to give all stakeholders time to plan for what's next, and to continue to provide input to the CMS and ONC. In the meantime, existing regulations—including meaningful use Stage 3—are still in effect.
Concerning interoperability, we now have clear guidance about the “best available” standards and implementation specifications through the ONC's 2016 Interoperability Standards Advisory. HIMSS believes this guidance is part of what has been lacking to help advance interoperability more rapidly.
We have also seen a tremendous amount of collaboration among electronic health-record vendors on interoperability, particularly at the annual Integrating the Healthcare Enterprise North American Connectathon, held this past Jan. 25-29 at the Global Center for Health Innovation in Cleveland. More than 500 systems engineers from competing companies participate each year in this neutral setting, testing the interoperability of their systems with other vendor systems. This commitment demonstrates vendors' efforts to ensure their systems can share, rather than block information.
In addition, seven vendors have achieved certification of their health IT products through HIMSS, a process that involves rigorous testing of the interoperability of EHR and health information-exchange systems.
Once we get further along on value-based payments, interoperability collaboration will intensify because of the clinical integration that will be required. If you have to demonstrate how you're improving population outcomes through the care you give, interoperability must be in place. More important, patients will increasingly expect—and demand—secure, electronic connectivity with their care providers.
Studies on telehealth and remote patient monitoring have shown care improvements and cost savings. For example, remote patient monitoring programs have helped decrease hospital readmissions for heart-failure patients, improve diabetes management and reduce hypertension. Also, telehealth helps empower patients to better self-manage their health and wellness.
The recently introduced CONNECT for Health Act would eliminate many of the restrictions on telehealth reimbursement, allow for remote patient monitoring of qualifying Medicare patients, remove Medicare reimbursement restrictions, and support cost savings and expanded access to care. It would give qualifying providers for MIPS and alternative payment models the ability to start incorporating telehealth and remote patient monitoring without those restrictions on their practice as they transition to meet new MACRA objectives.
We are headed toward a day when providers will be making their services available when and where patients need them and want them. There will be great demand for telehealth services and the health IT that drives them. How patients and providers relate to each other will change as a result.