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ONC's DeSalvo issues next health IT challenge: Build interoperable EHR systems

"We have not reached our shared vision" DeSalvo says about the EHR industry, during HIMSS 2014 speech


 

Interoperability of electronic health record (EHR) systems is now a national priority, according to Karen DeSalvo, MD, MPH, newly appointed National Coordinator for Health Information Technology, an entity within the U.S. Department of Health and Human Services leading the country’s adoption and use of health information technology (HIT).

“We have to ensure that HIT, an interoperable network of information and data flow connects providers and patients across the continuum. The country is counting on us to provide the information and data necessary to make better, more informed healthcare decisions. We have to get it right.”

DeSalvo challenged thousands of HIT professionals at HIMSS 2014 in Orlando to work collaboratively to build a truly interoperable EHR system that links providers in primary care with other specialties, and hospital systems, regardless of the IT vendor or platform.

“We have made impressive progress on our infrastructure, but we have not reached our shared vision of having this interoperable system where data can be exchanged and meaningfully used to improve care.”

And there is great urgency in developing these systems and solutions, DeSalvo says.

“As a nation, we are also facing a financial disaster with a healthcare system that is breaking the bank for all employers and for each of you as individuals. We are facing a looming threat that we will have to cut costs with an axe rather than the precision of a scalpel through informed evidence-based approaches. We have to act,” she says.

The end-goal will be to deliver the triple aim: improving care, improving the experience for patients, and reducing costs. Technology can deliver on this promise, DeSalvo says, and there have been many examples of successes in reducing costs as they relate to preventing hospitalizations and trips to emergency room departments, to name a few. But those successes have to be “brought to scale” for the rest of the country.

While Accenture predicts the global EHR market will hit $22.3 billion by the end of 2015, it doesn’t mean physicians are happy about the usability of these systems.

In fact, a recent Medical Economics survey of physicians noted widespread frustration (70% of respondents) with the usability of these systems. High costs came in second for nearly half of those physicians responding to the survey.

On this issue, DeSalvo says, “We know that we have had widespread adoption, but we have challenges to overcome with usability of EHR products and user interfaces. We need to better understand safety. We need to make sure that we can electronically measure the value of care… We need to continue to train our workforce. We need to balance the aspirations for the promise of HIT with the burden on providers, not only on meaningful use, but all the expectations in a very dynamic regulatory environment.”

The Centers for Medicare and Medicaid Services (CMS) has added physician quality measures for diabetes and heart disease treatments to Physician Compare, the website designed to help patients select providers.

President Barack Obama is including increased funding toward medical school programs for internal medicine, pediatrics, and family medicine in his 2015 budget proposal. But Medicare plans to cut payments to practicing physicians.

The American Medical Association says it’s “deeply concerned” that a contingency plan has not been put in place if issues occur during ICD-10 testing this month.

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Analysis of data at one of the nation's largest Patient-centered Medical Home pilots finds limited improvements in costs and patient outcomes.


Anonymous
There is no incentive for vendors to share information, no wonder they are slow. ONC is depending on all of us to pressure our vendors to do this, see MU2 requirements. WE don't get the money because THEY don't do interoperability. This whole discussion just shows how far behind the US was -- we didn't even see the interoperability issue looming.
Mar 5, 2014
Anonymous
The backwards approach that was taken with EHRs is confirmed by this statement from the ONC. The need for interoperability was obvious form the start, and the idea that it was not MANDATED from the start is disappointing to say the least.
Mar 5, 2014
Dr. Bryan
Honestly, interoperability between systems is exactly what doctors want. Everything else in the Meaningful Use program is just windows dressing at best and in general a distraction for vendors trying to produce a good product. I hope this is not seen as a visionary statement. This is like someone proposing the Golden Rule like it was a fresh new plan. Anything which has distracted the industry from interoperability has wasted time and money. Unfortunately, we a re long ways from real interoperability and most of MU is only wasting our time.
Mar 4, 2014