The American Medical Informatics Association (AMIA) recently held a briefing on Capitol Hill to unveil the findings and recommendations from a new paper, detailing ways that policymakers should focus on liberating data for patients, improving interoperability for clinicians, and enhancing the capacity for research and innovation to impact patient care. The paper, “Crossing the Health IT Chasm: Considerations and Policy Recommendations to Overcome Current Challenges and Enable Value-based Care,” is published in the Journal of the American Medical Informatics Association in tandem with the briefing.
Over the last five years, the US health care system has made a digital transformation faster than any other industry in modern times. However, today’s health IT infrastructure remains largely a collection of systems unable to deliver on promised benefits. “Crossing the Health IT Chasm” looks at our current health care landscape through the lenses of a patient, a provider, and the research and innovation community. It includes 17 policy recommendations to help health IT better support a value-based system of health, care, and research.
Paper authors developed a vignette to illustrate the demands on health IT from multiple points of view, focusing recommendations to address key gaps between the idealized and current experience for these three perspectives. The vignette envisions a not-too-distant future where patients access and transmit medical records from previous providers to new ones or providers can prescribe the use of mobile health applications to help patients control their conditions. The vignette also demonstrates how health IT makes clinical documentation simpler and identifying potential patients for a clinical trial easier. These scenarios are possible using today’s health IT, but they are far from commonplace.
Specific policies are needed to accomplish the following:
- enable better patient access to data in a computable format;
- improve interoperability in a context of application programming interfaces (APIs);
- simplify clinical documentation for reimbursement and quality measurement;
- more readily engage patients in research; and
- foster an ecosystem of safe, effective, and secure health applications.
“These recommendations are meant to help decision makers understand that the idealized vision for our digitized health care system is within grasp,” says lead author Julia Adler-Milstein, PhD, an associate professor at the University of Michigan’s School of Information. “Coordination—above all else—is how we take the health IT tools of today and achieve the promise of better patient care of tomorrow.”
Speaking at a briefing on Capitol Hill in Washington, D.C., AMIA President and CEO Douglas B. Fridsma, MD, PhD, FACP, FACMI, said, “We have made great progress in adopting EHRs in the last six years, but now our charge is even more difficult. Now, we must develop and implement strategies that allow all stakeholders—patients, clinicians, researchers, developers, and policymakers—to truly benefit from a connected, innovative health ecosystem. Policy recommendations developed in this paper have given decision makers a host of options necessary to accomplish this.”
To support “Crossing the Health IT Chasm,” AMIA issued a set of policy action items identifying several immediate, near-term, and future actions policymakers can take to improve patients’ access and use of their data, improve interoperability and clinical utility of patient data, and enhance the capacity for research and innovation to impact patient care.
Specific immediate action items include the following:
- clarifying a patient’s HIPAA “right to access” to include a right to all data maintained by a covered entity’s designated record set;
- encouraging continued adoption of 2015 Edition Certified Health IT so that standards-based APIs, published in the public domain, become a standard feature and can continue to be deployed by providers; and
- making effective Common Rule revisions as finalized in the January 19, 2017, issue of the Federal Register.
“Crossing the Health IT Chasm” was based, in part, on the findings and recommendations of AMIA’s EHR 2020 Task Force Report and, in part, on the outputs of AMIA’s 2015 Policy Invitational. The paper was coauthored by Julia Adler-Milstein, PhD, an associate professor at the University of Michigan’s School of Information; Peter J. Embi, MD, MS, president and CEO of Regenstrief Institute, Inc; Blackford Middleton, MD, MPH, MS, chief informatics and innovation officer with Apervita; and Neil Sarkar, PhD, MLIS, founding director of the Brown Center for Biomedical Informatics.
Source: American Medical Informatics Association