As the Centers for Medicare and Medicaid Services moves to new payment models based on value rather than volume, a lot more will be asked of health IT technology and the vendors who sell them to providers, according to CMS Acting Administrator Andy Slavitt.
Slavitt told the nation’s largest physician group on June 13 that the burden needs to be on the vendors, not the end users, to deliver on the promise of health IT and its potential benefits to transform healthcare.
Speaking before the American Medical Association’s annual meeting in Chicago, he said CMS has heard the calls for “putting more pressure on technology vendors” and less on physicians. The goal, Slavitt asserted, must be to “make healthcare technology a tool” serving clinicians and patients.
“This is particularly true in the area of what many call interoperability,” observed Slavitt, who argued that interoperable health information would enable physicians to do tasks as simple as tracking referrals when a patient sees another specialist or visits a hospital—capabilities that don’t exist today, he contends.
He told the AMA audience about a conversation with a specialist in Chicago who complained that electronic health record systems simply don’t talk to each other, making it impossible to view patient records in those kinds of scenarios.
Besides relief from Meaningful Use requirements, Slavitt said that health IT interoperability is the “number one ask of many physicians.”
To help address these challenges, the CMS chief remarked that EHR vendors—and the providers that use their products—will now be required to open their application programming interfaces (APIs) “so data can move in and out of an application safely and securely.”
APIs, which enable a software program to access the services provided by another software program, are included in the final Meaningful Use Stage 3 rule requiring certified EHR technology to provide an API through which patient information can be viewed, downloaded and transmitted to a third party.
In addition, APIs are included in the 2015 Edition of Health IT Certification Criteria, which requires certified EHRs to demonstrate the ability to provide a patient-facing app access to the Common Clinical Data Set via an API.
“Systems will need to adapt to your needs,” concluded Slavitt. “Long-time frustration won’t disappear right away,” but he said “it is essential that physicians not only participate in but having a leading voice in the change that is ahead.”
In response to Slavitt’s comments, Leigh Burchell, chair of the EHR Association and vice president of government affairs at Allscripts, agrees that physicians must be engaged if the healthcare industry is to achieve health IT’s potential to help transform the healthcare delivery system. However, she contends that technology alone is never going to be the answer for vexing industry issues.
“Interoperability is a critical area of focus for us all. APIs and other tools will certainly move us ahead, but no one stakeholder can resolve all the issues that stand between where we are today and where we want to be in the secure sharing of patient information across provider organizations—issues such as HIE governance, data ownership and privacy agreements, and a consistent patient identity approach across disparate systems,” says Burchell.
Morgan Reed, executive director of ACT|The App Association and acting director of the Connected Health Initiative, said he supports Slavitt’s position.
“The United States is the largest consumer of healthcare services around the globe. But, physicians are unlikely to adopt new technology if it interrupts workflow or puts a patient at risk,” says Reed. “The lack of interoperable health information systems is an impediment to innovation that ultimately harms patients. We agree with Administrator Slavitt that there should be pressure on major vendors to make systems work well together.”