Addresses health IT usability, interoperability, and development and adoption of emerging technology
March 20, 2020 (ACP) – Health information technology (IT) and digital health tools are supposed to improve patient care. Too often, however, they burden medical professionals and take their attention away from patients. The American College of Physicians is spearheading the national health IT conversation by offering a new direction.
“Technology continues to rapidly advance and will become an even bigger part of our health care system moving forward,” said Brooke Rockwern, ACP senior associate of health IT policy. “Laying a solid policy foundation for development and implementation of these technologies is critical.”
ACP offers its expertise to policymakers and stakeholders in a free report titled, “Envisioning a Better U.S. Health Care System for All: Health Care Delivery and Payment System Reforms.” The report is one of a series of policy papers released as part of a collection titled, “Better Is Possible: The American College of Physicians' Vision for the U.S. Health Care System.” All the reports appeared in the January 2020 issue of Annals of Internal Medicine.
“Our policy highlights the need for these technologies to enhance the patient-physician relationship, facilitate communication across the care continuum, and support improvements in patient care,” said Rockwern, one of the report's coauthors. The report provides several specific recommendations that were developed and prioritized “based on evidence-based research and the extensive feedback we collected from ACP members as well as our expert committees, including the Medical Informatics Committee,” Rockwern said.
The recommendations highlight the following areas:
Usability of Health IT. “Health IT should be developed and improved upon based on patient and clinician needs, and patients and clinicians should be involved in the usability testing of these technologies to make sure the industry got it right,” Rockwern said.
Interoperability. ACP recommends that interoperability efforts are focused on consistent implementation of health IT standards across health IT systems or digital technology. “The ability to communicate and exchange meaningful and actionable information across the health care system is critical,” Rockwern said. “Everyone across the industry, including electronic health record (EHR) vendors, payers, developers, and clinicians, needs to be on the same page regarding how to exchange that information securely, privately and meaningfully. Opening the floodgates to exchange massive amounts of health data may help some in the industry, but patients and clinicians need meaningful, context-rich, individualized presentation of data that allow them to make better care decisions together.”
ACP also calls for testing and implementation of health IT standards and interoperability rules to be conducted in stages to minimize negative effects on patients, privacy, security, clinical workflow, and data visualization and interpretation.
Development and Adoption of Emerging Technology. “There is a lot of promise in emerging technologies to enhance patient-centered care,” Rockwern said. “These new tools must be thoroughly vetted and shown to be effective in improving care delivery and health outcomes before being widely implemented across the system. Once vetted, value-based payment reforms should support the adoption of these technologies.”
What happens if policymakers and stakeholders embrace these recommendations? “If that happens, the current paradigm of the burdensome EHR will flip to one where the technology is seamlessly enhancing the experience of care for patients, physicians and their care teams,” Rockwern said. “Instead of an added step in their workflow, technology can decrease existing administrative burdens, allow for better communication across care teams and health systems, and give physicians more time with their patients to review and discuss meaningful information regarding their health care and engage in shared decision-making.”
What's next? “The environment is rapidly expanding and changing and will continue to do so,” Rockwern said. The Centers for Medicare & Medicaid Services and Office of the National Coordinator for Health IT (ONC) recently released long-awaited and significant final regulations outlining requirements for increased patient access to health data and health data exchange. “Our health IT policies within the New Vision help us respond to these regulations and continue conversations with the administration as they implement the regulations over the next couple of years,” Rockwern said.
Meanwhile, ACP recently responded to the ONC's draft version of the Federal Health IT Strategic Plan for 2020-25. “Our comments reiterate much of what our health IT recommendations in the New Vision lay out,” Rockwern said. “These types of comment opportunities, as well as our ongoing outreach and advocacy with federal partners and industry-wide stakeholders, are a great way to advance our recommendations and apply them to more specific initiatives.”
Moving forward, she said, “issues of data privacy are on everyone's radar, including ACP's, and will continue to be an area of focus, as well as diving into more detail on how emerging technology can be appropriately and meaningfully incorporated into day-to-day practice.”
The ACP policy paper “Envisioning a Better U.S. Health Care System for All: Health Care Delivery and Payment System Reforms” is available on the Annals of Internal Medicine website.