Verma keynote provides the buzz: As we have been hinting here at Healthcare Informatics, HIMSS18 will be much heavier on the policy front than HIMSS17 was. On Tuesday morning, CMS (the Centers for Medicare & Medicaid Services) Administrator Seema Verma confirmed our speculation by dropping a major policy announcement in the morning’s opening keynote: the launch of a new initiative called “MyHealthEData,” aimed at revolutionizing the relationship of U.S. healthcare consumers to their patient data.
What is the significance of this initiative? According to a CMS news release, “MyHealthEData will help to break down the barriers that prevent patients from having electronic access and true control of their own health records from the device or application of their choice. Patients will be able to choose the provider that best meets their needs and then give that provider secure access to their data, leading to greater competition and reducing costs.”
At the same time, Verma, who was introduced by Jared Kushner, who is in his role as the lead in the White House’s Office of American Innovation, also announced the launch of Medicare’s Blue Button 2.0—a new and secure way for Medicare beneficiaries to access and share their personal health data in a universal digital format, according to CMS. An example of Blue Button 2.0 being used in action would be a patient accessing and sharing his or her health data, including prior prescriptions and treatments, with a new doctor. Verma noted that while the Blue Button initiative has been around for years, the data has been in raw form, such as a PDF or Excel document, without useful context.
Verma talked more about patient-centered healthcare, recalling one anecdote in which a doctor she recently spoke with had twins, and it took him, a doctor, six months, to access his children’s records. Verma also had strong words about the need for better privacy and security of patient data, as well as attesting that the meaningful use program is undergoing a “complete overhaul.” The CMS Administrator additionally said the government will not tolerate data blocking. Read Mark Hagland’s full report on Verma’s keynote here.
Early HIMSS numbers are in: 42,608 attendees versus 40,453 at this time last year
Heard at HIMSS: A Twitter thread among various industry folks on Tuesday included a debate on if the Trump administration’s dialogue on healthcare transformation is "cheap" or not. Some highlights for you to be the judge:
ONC tidbits: The Office of the National Coordinator’s (ONC’s) full team was present for the annual ONC Town Hall at HIMSS, including National Coordinator Donald Rucker, M.D. The federal health IT agency spent most of the hour-long session by listening and responding to questions from attendees. Some of the most interesting nuggets heard from yours truly:
---Rucker on data liquidity: “We have an extraordinary opportunity to use modern computing power to change the way healthcare is delivered. Amazon can use machine learning to figure out which [product] we should buy, that we don’t even need, but we don’t have any access to data to figure out if the treatment we’re being offered is working well for other folks.”
---Genevieve Morris, principal deputy national coordinator for health IT, was asked if ONC has considered setting up a health information exchange (HIE) network in which ambulatory providers could connect for free since many cannot afford HIE participation. Morris agreed that HIEs have not been overly successful in connecting ambulatory providers, and to that point, a key consideration in TEFCA (ONC’s Trusted Exchange Framework and Common Agreement) was to make it easier for them, including long-term care and behavioral health providers. “Some existing HIEs do offer free services for ambulatory doctors,” Morris offered.
---Fleming on clinician burden: John Fleming, M.D., deputy assistant secretary for health technology reform, talked about how current documentation guidelines were developed in the 1990s and were purposed for doctors to get paid for how much they document. It was in those days, said Fleming, in which the industry was “still dreaming about EHRs.” But now, with the influx of EHRs, clinicians are spending too much time checking boxes and inputting data into these systems, with reimbursement based on that documentation. As a result, Fleming has said he has seen clinician office notes as long as 20 pages. That could lead to providers on the other side not being able to decipher the note, having to ask patients to tell them what the previous doctor said—or in other words, starting from scratch.
---Data blocking update: One attendee said he hasn’t heard much news about information blocking lately, despite warnings coming in different forms over the last few years. An ONC official noted that the 21st Century Cures Act “calls out data blocking and lays out a definition for it. It’s been on our radar for a number of years. And we are asked to identify the exceptions, too. Where might [data blocking] be happening and what is OK?” The official did add that ONC isn’t allowed by law to comment on some aspects of this, but the agency is working hand-in-hand with the Office of Inspector General (OIG), a department which is expected to enforce this provision, as per the Cures legislation.
CommonWell executive director strikes back: Late last week, KLAS released a telling interoperability report in which it concluded that the services of the CommonWell Health Alliance are not providing much value right now. But the Alliance’s Executive Director Jitin Asnaani predictably responded in defense of his organization in a one-on-one interview with Healthcare Informatics. Asnaani called parts of the KLAS report “totally bogus” and said, “Every time the next provider gets on board and connected, it provides value to the entire [CommonWell] network.” Read the full interview with Asnaani here.
HIT’s biggest names talk interoperability: Throughout the last two days, our Heather Landi has attended an array of interoperability sessions, in which some of the industry’s brightest minds took part. Aneesh Chopra, president of CareJourney, (formerly NavHealth), Christopher Ross, Mayo Clinic’s CIO, and Micky Tripathi, Ph.D., president and CEO of the Massachusetts eHealth Collaborative, all had stimulating things to say about the industry’s current interoperability trajectory, recapped nicely in this article by Landi.
Health plan leaders tout the value of HIE data: The value of HIEs for managed care plans and payers was a key area of focus during several education sessions on Tuesday. Two health plan leaders specifically shared how their organizations are leveraging HIE data to improve quality measures, care management and to close care gaps. Dirk Rittenhouse, director of clinical data acquisition and analytics at Anthem, noted how HIE data provides a more accurate member profile and how the company utilizes analytics capabilities provided by Kansas Health Information Network (KHIN) for value-based care, population health and predictive analytics. “The type of data that are looking for out of HIEs is clinical data that is incremental and additive,” he said. “HIEs are great for payers; they have dealt with the governance issues and the connectivity issues.”
Speaking further on HIE value, Andrea Gelzer, M.D., senior vice president and corporate chief medical officer, AmeriHealth Caritas, a Medicaid managed care plan based in Philadelphia, added, “If you are a large commercial insurer and have plans in 50 states, until you see value from HIEs, it’s hard to justify the resources to participate in HIEs in 50 states. We are seeing value.”
