- John Halamka, chief information officer at Beth Israel Deaconess Medical Center and member of HHS' Health IT Standards Committee, has some suggestions for how the Trump administration should tackle five different health IT challenges, starting with enabling infrastructure.
- The easiest way to enable infrastructure and improve data sharing across disparate electronic health record (EHR) systems would be to create a national healthcare identifier, with a national directory of provider electronic addresses to facilitate data exchange, he wrote in a blog post.
- The other four issues the new administration should focus on, according to Halamka, are: Reducing clinical burden, clinician incentives, cybersecurity, and innovation.
Halamka’s comments come as the Senate is considering Rep. Tom Price’s (R-GA) confirmation to lead HHS. To date, no one has emerged as a possible health IT leader in the new administration.
On the issue of infrastructure, Halamka notes it’s not only about improving data sharing across the 50 states. “Also, the Federal Government needs to practice what it preaches – if DOD and VA don’t share with each other or if all Federal agencies don’t abide by industry-adopted standards and business practices, then the private sector cannot be criticized,” he writes.
A recent report from HHS’ Office of Inspector General criticized CMS’s lack of IT infrastructure to collect the data allowed by the Medicare Access and CHIP Reauthorization Act (MACRA) final implementation rule.
Halamka also urges the administration to reduce the number of prescriptive regulations and focus more on outcomes, citing clinical burnout. According to a study in the Annals of Internal Medicine, 54% of American physicians report burnout over regulatory and administrative tasks — and the level is rising.
To change physician behavior, think incentives, Halamka says. “There are only 3 ways to influence a physician – pay them more, improve their quality of practice life, or help them avoid public embarrassment (malpractice assertions, poor quality scores, high cost compared to their peers etc),” he writes. “If the right tools are created that help with those three items while achieving policy goals, they will be adopted.”
With the number of cyberattacks on healthcare organizations rising, the government should work with industry and cybersecurity experts to identify threats, mitigate risks and explore new technologies like blockchain, Halamka adds. HHS’ Office of the National Coordinator for Health Information Technology has recognized the promise of blockchain and launched a challenge last July to use the technology to solve privacy, security, and scalability issues in EHRs.
Finally, Halamka notes that regulatory compliance and certification of EHRs is hurting innovation. With high levels of EHR adoption, vendors should be marketing their products based on technological advances and greater efficiencies, not certification, he says.
HHS has supported a number of initiatives aimed at advancing innovation in health IT. Last year, ONC awarded $1.5 million to seven organizations attempting to innovate standards-based solutions for the flow of health information to improve healthcare and enhance the provider and patient experience.