ORLANDO --- The next administrator of the federal government's office for health information technology will need to empathize with a provider community looking for answers and likely will have fewer tools to help them, according to IT experts.
The yet-to-be-named head of the Office of the National Coordinator for Health Information Technology at HHS will need to improve interoperability of health systems and come up with a plan to better match patients with their medical records --- all with potentially less money to do so.
Health IT experts meeting in Orlando, Fla., this week at the Healthcare Information and Management Systems Societies said President Donald Trump should choose a clinician to lead the office. The six prior leaders since the role's inception have been physicians.
For practical reasons, the candidate should have a background first as a provider, then as an IT geek.
“When I hire people, I can hire a clinician and make them understand IT,” said Dr. Paul Veregge, CIO and chief medical information officer of the University of Mississippi Health System. ”Doing the reverse is much harder.”
A new ONC leader should have the courage to take a hard look at the Obama administration's HIT policy, which was focused on EHR adoption using more than $37 billion in financial incentives as leverage, and recalibrate the policy, said Dr. Peter Basch, medical director of ambulatory EHRs and HIT policy at MedStar Health.
Dr. Karen DeSalvo, an ONC chief under President Barack Obama in 2016 set a national interoperability goal for all providers to be able to exchange a core set of patient data by the end of 2017.
Trump's history as a real estate mogul and his interest in putting free market proponents in administrative positions will likely mean he'll make health IT decisions that increase competition in the marketplace. It's also likely he'll continue with efforts to lower healthcare costs.
Basch said the current value-based payment system makes artificial incentives for EHRs or interoperability obsolete.
Basch noted that the first ONC head, Dr. David Brailer, used his bully pulpit, not grants, to encourage IT adoption and use.
Whoever it is, the new ONC leader needs to help healthcare organizations try to extract maximum value from their multi-billion investments in health IT over the past five years, said Russ Branzell, president and CEO of the College of Healthcare Information Management Executives.
An ONC report under the Obama administration said as of 2015, 96% of hospitals and 78% of physician offices were using certified EHR technology.
Branzell said healthcare organizations need another three to five years to reach peak performance with their existing EHR systems.
Bart Carlson, CEO and chief patient advocate of Azuba, a Naperville, Ill., developer of a cloud-based medical records access platform for patients, providers and payers wants the new ONC chief to more heavily promote patient engagement, but “I think we're moving in the right direction.”
One largely under-reported role established by Congress for the ONC is coordinating federal health IT programs.
HIT veteran David Muntz said the ONC chief should start by working with both the Military Health System and the Veterans Health Administration at the Veterans Affairs Department.
“I see it as a way to save a lot of money,” Muntz said. The two sprawling and frequently fractious federal integrated delivery systems burned through vast sums before finally achieving interoperability between their different EHR systems.
“I think we need somebody who is very open and listens well,” said Doby Fisher, chief clinical officer for Forward Health Group, a HIT company working in population health management. It should be someone who takes a bi-partisan approach and has foresight to steer policy “based on our long-term healthcare goals.”
The next ONC leader should promote innovation, particularly the development of products by small vendors and developers, and press hard for industry consensus around uniform interoperability standards and implementation specifications, according to Dr. Art Papier, co-founder and CEO of VisualDx, which develops diagnostic support tools.