Healthcare Stakeholders Offer New Health IT Vision

Ken Terry

November 14, 2014

With the government's electronic health records (EHR) incentive program struggling and running low on funds, a broad array of private sector stakeholders, led by the eHealth Initiative (eHI), has launched an ambitious new effort to drive the information technology (IT)-enabled transformation of the healthcare industry forward.

Dubbed the "2020 Roadmap," the initiative is "a public-private collaborative, creating a shared vision of the strategies, policies and actions that are required to transform our healthcare system by the year 2020," according to a report released by the participants. The roadmap is also a bid to break the "gridlock" that has hampered the resolution of key issues in health IT, said Jennifer Covich Bordenick, chief executive officer of eHI, at a press conference announcing the 2020 Roadmap.

eHI, which has been around for many years, describes itself as "a Washington, DC-based, independent, non-profit organization whose mission is to drive improvements in the quality, safety, and efficiency of healthcare through information and information technology."

Among the other participants in the 2020 Roadmap are such diverse players as the American Medical Association, Mayo Clinic, Marshfield Clinic, Siemens, Cerner, and United Healthcare. The roadmap grew out of roundtable discussions by 150 industry executives last September, and it represents an effort by the private sector to address health IT challenges in the context of healthcare reform.

Nevertheless, Covich emphasized, the federal government must and will be involved in the 2020 Roadmap. eHI will collaborate with the Office of the National Coordinator for Health IT (ONC), as that agency develops its own interoperability roadmap, which is scheduled to be released for public comment in January. Discussions will also be held with the Centers for Medicare & Medicaid Services, which runs the meaningful use incentive program, and the US Food and Drug Administration, according to the 2020 Roadmap report.

"One Part of a Larger Effort"

Responding to a question at the news conference about how the 2020 Roadmap complements the meaningful use program, Steven J. Stack, MD, president-elect of the American Medical Association, said, "It's a more comprehensive approach to high-quality care. The roadmap goes far beyond meaningful use. It addresses the needs of payers, patients, and providers. Meaningful use is just one part of a larger effort."

The 2020 Roadmap report calls for significant changes in the meaningful use program, including an extension of the period between meaningful use stage 2 and stage 3 and allowing more time for providers to implement health IT. However, the report did not oppose continuation of the program, which the participants view as essential to health IT progress.

"Meaningful use has accelerated change," said John Glaser, chief executive officer of healthcare services for Siemens, at the press conference. "But the program needs to evolve and shift to an emphasis on patient outcomes, away from the features and functions of EHRs."

The three focus areas of the 2020 Roadmap are aligned business and clinical motivators, interoperable systems, and appropriate data access and use. The report's priorities and recommendations for federal policymakers and the private sector include these key points:

  • Health IT implementation should enable delivery system transformation "at an effective and feasible pace."

  • Interoperability should be patient-centered and meet the Institute of Medicine's goals for high-quality care.

  • Appropriate data access and use should emphasize privacy and security in the context of inoperability.

  • Providers should be rewarded for outcomes, rather than complying with specific requirements.

  • Health information exchanges must be flexible to deal with diverse market conditions.

  • There should be more payer incentives for patient-focused care and for the IT tools needed to support that care.

Sam Ho, MD, executive vice president and chief medical officer of UnitedHealthcare, stressed the need for private payers to step up to the plate to incentivize health IT-enabled activities. Among these activities, he told the press conference participants, is the use of health IT to engage patients to improve population health. Another, more specific, example is the electronic transfer of care plans among providers who care for complex patients.

Glaser spoke of the need to spread health IT to the many types of organizations and healthcare professionals that are ineligible for government EHR incentives, such as post-acute-care providers, and Daniel Garrett, principal and health IT practice leader at PwC, a consulting firm that is helping to support the 2020 Roadmap, called for other industry stakeholders, such as drug companies and pharmacies, to be involved in the discussion.

Covich emphasized that much remains to be done on the 2020 Roadmap, which is really a framework for discussion. She promised a series of conferences in 2015 that will "dive deeper" into the key issues.

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