Speaking to an optimal audience, Sylvia Mathews Burwell, the U.S. Secretary of Health and Human Services, announced on Monday to an overflow audience at HIMSS16 a major federal initiative that has gathered together industry leaders to advance data-sharing, consumer access to healthcare data, and interoperability. Appearing live in the 7,000-seat Palazzo Ballroom at the Venetian-Palazzo-Sands Expo Center in Las Vegas (and hundreds more in a nearby overflow room), Mathews Burwell announced that “[C]companies that provide 90 percent of electronic health records [EHRs] used by hospitals nationwide as well as the top five largest private healthcare systems in the country have agreed to implement three core commitments,” according to a Department of Health and Human Services (HHS) news announcement released at the same time.
According to that announcement, the three commitments are as follows: first, “Consumer Access: To help consumers easily and securely access their electronic health information, direct it to any desired location, learn how their information can be shared and used, and be assured that this information will be effectively and safely used to benefit their health and that of their community.”
Second, “No Information Blocking: To help providers share individuals’ health information for care with other providers and their patients whenever permitted by law, and not block electronic health information (defined as knowingly and unreasonably interfering with information sharing).”
And third, “Standards: Implement federally recognized, national interoperability standards, policies, guidance, and practices for electronic health information and adopt best practices including those related to privacy and security.”
In alphabetical order, HHS’s announcement indicated the following vendor companies that had agreed to participate in this initiative: Aprima, athenahealth, Allscripts, Cerner, CPSI, Epic, GE Healthcare, Intel, McKesson, MedHost, Meditech, NextGen, Philips, SureScripts, Optum, and Greenway Health.
The healthcare systems that have signed onto the initiative are, in alphabetical order, Ascension Health< Carolinas Healthcare, Catholic Health Initiatives, Community Health Systems, Dignity Health, Geisinger Health System, Hospital Corporation of America (HCA), Johns Hopkins Medical, Intermountain Healthcare, Kaiser Permanente, LifePoint Health, Mountain States Health Alliance, Partners Healthcare, Tenet Healthcare, Trinity Health, and the University of Utah Health care.
And the healthcare professional associations that have committed to this initiative are the American Academy of Family Physicians (AAFP), American College of Physicians (ACP), American Medical Association (AMA), American Medical Informatics Association (AMIA), American Hospital Association, AHA), American Health Information Management Association (AHIMA), American Society of Clinical Oncology (ASCO), Center for Medical Interoperability, College of Healthcare Information Management Executives (CHIME), CommonWell, the Health Information and Management Systems Society (HIMSS), Healthcare Leadership Council (HLC), Premier healthcare alliance, Sequoia Project, National Partnership for Women and Families, and National Rural Health Association (NRHA).
Laying Out a Federal Healthcare Strategy
Mathews Burwell’s announcement capped a speech that framed HHS’s current strategies, which she laid out for her several-thousand-strong audience. She pointedly articulated a multi-part strategy for the healthcare IT leaders gathered together at HIMSS16. “The first thing we’re focused on,” she said, “is changing the way we pay doctors and other providers, so that we pay for quality of care instead of quantity of service. Second,” she said, “we’re improving care delivery by promoting coordination and integration. And finally, we’re working to unlock healthcare data and information, so providers are informed and patients are empowered.” Importantly, Secretary said, “technology isn’t just one leg of that table. It’s a crucial support for all those strategies. Healthcare data is the language that patients use to tell the story of their health. It’s the lines of the network that help doctors to work for one patient or a whole (network). And at HHS, and other agencies, technology is the lens through which we can improve public health.”
Mathews Burwell noted that, “In six short years, we’ve tripled the adoption of EHRs. Today, three-quarters of physicians use them, and nearly all hospitals do. But we still have a lot of work to do to get the real value of this information for providers and consumers. As we look at our current way of doing things, if often falls short
First, consumer access often remains a challenge. It’s great to have an electronic record; but if it’s not easily accessible by doctors and patients… Second, the information is too often unknowingly or knowingly blocked, either because of business barriers, or HIPAA. Finally, without agreement on a common data alphabet, our technology is stuck, speaking different languages.”
Thus, she laid out the rationale for the announcement that she then made to the audience and which was released online by the agency.
The Human Dimension: Flint and Beyond
Mathews Burwell made a point to frame her speech in human terms. Indeed, she began her oration by referencing a public health crisis that has been unfolding in the news headlines in recent weeks. “While we are here” in Las Vegas, she noted, “members of our HHS team are in Flint, Michigan, helping with recovery efforts” in the lead contamination crisis in that community. “Two weeks ago, I traveled there to see that work and get a better understanding of the challenges the residents there are facing. The town is still reeling from a breach of trust—but it starting to recover. Before the national spotlight, Dr. Mona Hanna-Attisha, a pediatrician [Mona Hanna-Attisha, M.D., a pediatrician in Flint who practices at that city’s Hurley Medical Center], was fighting for the children of that city. She had learned that the city wasn’t doing corrosion control. She knew the danger lead posed and began what she called a crusade. She began mining Hurley’s electronic health records to compare the health records of children in the area and outside it. By mapping geographic variations, she quickly discovered that the percentage of children with lead poisoning had doubled and in some cases tripled. She said, if we had been on paper, it would have taken us years to get these results.” Dr. Hanna-Attisha’s work, Mathews Burwell, emphasized, shows the value of EHRs in supporting public health and communities. “Unlocking that data” in EHRs, she said, is a key part of our efforts to transform the healthcare system to improve our efforts to transform the healthcare system to improve healthcare for all of us Americans. You may know this as delivery system reform: we see it as putting the patient at the center. We’re working to deliver a system that delivers better care; spends our dollars more wisely; and improves the health of communities.”
Mathews Burwell ended her speech on a personal note as well. First, she shared the story of a patient who had overcome tremendous health problems after she signed onto a program that helped patients better manage their chronic illnesses. Through that program, the patient, whom Mathews Burwell identified as Kim Blanton, was able to confer with her doctors and determine that her congestive heart failure and kidney disease medications were conflicting with each other and worsening her condition. Mathews Burwell than returned to the Flint story, saying that, “From the children of Flint to the Kim Blantons of the world, this transformation”—healthcare system reform, added to the benefits of insurance access under the Affordable Care Act—helps patients get healthier and build better lives. We are getting closer to our vision of a better, smarter, healthier health care system,” she said, adding that “I look forward to all we will accomplish together,” as federal agencies working with providers, insurers, vendors, consumer groups, and all the stakeholders in U.S. healthcare.
Mathews Burwell’s speech capped off the first day of HIMSS16, which, according to HIMSS staff, counted 39,881 attendees as of Monday, though more attendees are expected on Tuesday.