To get healthcare's powerful players to behave as desired, HHS and its various units are increasingly turning to the same playbook: naming and shaming bad actors.
Most recently, the CMS and the Office of the National Coordinator for Health Information Technology issued two proposed rules on Feb. 11 to spur interoperability and counter information-blocking.
Among the rule's provisions is to post a list online of healthcare clinicians and hospitals that block the transfer of patient information, with the goal of getting providers to curb the practice.
The rules also took a less obvious swipe at electronic health record system vendors, who after years of effort have yet to achieve full interoperability. The proposed rule would require that vendors make patient information available in a standard, easily manipulated format. That would allow app vendors to collect health records and patients to manage their health, with the potential of achieving effective interoperability without EHR vendors.
The strategy of naming bad actors already has been used in the administration's efforts to curb high drug prices. The CMS and the Food and Drug Administration have both sought to name drug companies that raise prices too high on Medicare or engage in anti-competitive tactics to deter generic-drug competition. In addition, pharmacy benefit managers are a target for increased disclosure of fees they are paid for drug management.
CMS Administrator Seema Verma didn't rule out similar tactics when asked if such “name and shame” tactics are going to be applied to other types of regulations.
“I think last year at HIMSS it was clear we are going to use every lever that we have to drive patients getting access” to their records, she said at a news briefing Feb. 12. “It is important that our system has interoperability and patients have access to their records and we will do everything we can to make that a reality.”
Some hospital executives say the rules, regardless of the approach, could lead to change if the various pieces fall into place. “There are a couple of things that have to happen,” said Aaron Martin, executive vice president and chief digital officer at Providence St. Joseph Health and managing general partner of Providence Ventures.
“One is it's going to be very powerful once we can get an efficient combination between claims data and clinical data, so that the patient has full control and can view not only what was billed for, but what was actually done. Both pieces of information carry value, but they're both incomplete,” Martin said. He said there also is consumer-generated data that patients need to willingly contribute to the discussion as well. That information is provided by Fitbit and other technology.
“The key thing is the combination of these data sets really matter,” he said.