Past ONC coordinators, HIT execs clash on HITECH value
- The Health IT for Economic and Clinical Health (HITECH) Act has largely succeeded in spurring EHR use, a group of former national coordinators wrote in The New England Journal of Medicine. The authors argue while the systems aren't perfect, they have overall been beneficial.
- Countering that argument in NEJM are two health IT executives who say the effort has faltered because of lack of infrastructure and too much regulation.
- Both parties suggest the way forward is to embrace standards and more open platforms.
While HITECH got most providers adopting health IT, it overwhelmed them with regulatory requirements like Meaningful Use and an inability to easily share digital information. The two perspectives show the competing views of the value of the HITECH program.
It's no secret that providers weren't hip to the idea of the Meaningful Use program. Many saw it as being too regulation heavy and said vendors played catch-up from a product perspective after EHR Stage standards were set. In addition, many felt that EHR platforms were too clunky to propel healthcare into a digital age.
“In a sense, we gave clinicians suboptimal cars, didn't build roads, and then blamed them for not driving,” wrote John Halamka, Beth Israel Deaconess Memorial Center CIO, and Micky Tripathi, CEO of Massachusetts eHealth Collaborative.
On the other hand, the care delivery industry is largely reluctant to change, so a slight force of hand through financial incentives, such as what Meaningful Use provided, wasn't a bad idea in theory to help spur tech adoption among providers.
By and large, the program worked if it was being measured on adoption alone. The HITECH Act’s Meaningful Use incentive program encouraged fast-paced adoption of EHRs, increasing use at eligible hospitals from 3.2% before the program to 14.2% after, according to a recent study published in Health Affairs. However, real challenges remain in terms of interoperability and usability, the researchers said.
An earlier report by the Robert Wood Johnson Foundation concluded that while HITECH promoted health IT adoption, it failed to achieve its broader goal of establishing a “highly effective and efficient system” due to challenges in technology, finance, governance and privacy and security.
Past national coordinators used their skills and talents to help drive that adoption and former National Coordinator Dr. Vindell Washington told Healthcare Dive last year that interoperability wasn't really possible until EHR tech adoption reached a tipping point among providers.
The NEJM paper reflects the past coordinators forward thinking on furthering digital advancements in the healthcare industry.
“We also believe that health IT should be easier to use and capable of integrating and displaying information in meaningful, actionable ways,” wrote former ONC chiefs Dr. David Blumenthal, Dr. Farzad Mostashari, Dr. Karen DeSalvo and Washington.
The former national coordinators highlighted the National Coordinator role will be essential going forward to bring together stakeholders in the space. "The ONC also has an essential role in coordinating federal agencies in developing guidelines for technology deployment — collaboration that must be complemented by private-sector–led innovation," the authors concluded. "Federal partners, especially the Veterans Health Administration and the Department of Defense, can model new innovations that promote the seamless flow of information for care delivery."
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