Aligning IT for value-based care

As the healthcare industry propels the transition to value-based care forward, discrepancies in technology advancement deter progress.

Of the widespread roadblocks to health information technology (HIT) advancement, physician burnout and reporting burden glaringly remain. According to an American Medical Association (AMA) study, physician spend at least 44 percent of their time on clerical and documentation tasks with 86 minutes every day, after hours, on electronic health records (EHRs). Many clinicians feel reporting regulations have shifted their roles from patient care to data entry and are urging faster industry resolution. As clinicians and health IT leaders speak out to better define the value in the full scope of value-based care, consider these four areas of progress.

Physician well-being
In the persistent swing to consumer-driven healthcare, where does that leave overburdened physicians? Clinicians are actively taking the lead to better define value-based care’s boundaries in relation to their own well-being. In a unified effort to combat physician burnout, medical practice dissatisfaction and increased suicide risk, the Collaborative for Healing and Renewal in Medicine published its Charter on Physician Well-being. Along with guiding principles for practice, the charter lays out societal, organizational, interpersonal and individual responsibilities to protect physician wellness and engagement. The hope is to renew the profession and reenergize physicians with a better work, life and mental health balance— all of which will translate into engaged, more meaningful patient care.

At the same time, more and more providers are raising their voices against industry government regulation. For example, with help from professional and advocacy groups like the College of Healthcare Information Management Executives (CHIME) and the American Hospital Association (AHA), more than 1,200 comments propelled adjustments to Medicare Access and CHIP Reauthorization Act (MACRA) year 2 requirements to lessen reporting, exemption and small practice requirements for reimbursement. This is just one of many recent examples of provider advocacy in action.

Industry initiative progress
With more boisterous rallying, progress toward industry change is happening. At a press briefing in March, U.S. Department of Health and Human Services (HHS) Secretary Alex Azar emphasized shifting away from accumulating data for the sake of reporting, instead aiming for actionable information for decision makers for improved quality, price and value. To directly address reporting burden, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC) of HIT have partnered under the 21st Century Cures Act to reduce Evaluation and Management (E&M) specifications for physicians. At HIMSS18, CMS announced the launch of the MyHealthEData initiative, which aligns with President Trump’s “Cut the Red Tape” focus. While the logistics have not fully deployed, ONC promises this will lessen documentation and billing requirements for providers for higher focus on direct patient care. This change emphasizes overhaul of E&M standards for the first time since the 1990s.

Putting patients in the driver seat
As the industry awaits meaningful use and E&M overhaul from MyHealthEData, the program is making new strides in another area of value-based care concern— patient data access. A recent study found that approximately 63 percent of patients do not know who holds or accesses their health information. In April, the ONC released its “Guide to Getting and Using Your Health Records” for consumer-driven healthcare. On top of educating about patient data rights and HIPAA, the resource provides tips for patients to access, check accuracy and share electronic health records for coordinated care. As the initiative comes to life, the goal is to form a health information ecosystem where patients can access and share health information, appointment details and claims data at the push of a button.

The CIO’s evolving role
While expectations from all spectrums of the end user heighten, IT leadership must stay ahead. The CIO role has expanded to require a combination of technical savvy, process improvement, negotiation and communication skills. They not only need to know their EHR systems and applications, but also workflow and operations. Now that EHRs are universally implemented, the responsibility evolves from running systems to optimizing, strategically staffing and budgeting them while capturing and using actionable smart data insights. In an active seat at the decision-making table, CIOs need to form strong partnerships with CMIOs and CFOs to ensure cross-departmental coordination for clinical reporting and reimbursement requirements.

As if that was not enough, hospitals look to CIOs for insight into the future of care. IT leaders have to anticipate and navigate competitive care possibilities and the tools that enable them like machine learning and AI. Under value-based care, the industry is on the cusp of total health journey transformation with consumerism. Healthcare is no longer just treating the sick; the entire meaning of healthcare is being redefined.

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