Submitted via www.regulations.gov
Ms. Seema Verma
Administrator
Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, MD 21244
Re: CMS-1694-P; Request for Information on Promoting Interoperability and Electronic Health Care Information Exchange through Possible Revisions to the CMS Patient Health and Safety Requirements for Hospitals and Other Medicare and Medicaid-Participating Providers and Suppliers
What are some of the most substantial health IT issues that are hindering the healthcare field? A study published in the Journal of the American Medical Informatics Association found that EHR functionalities that lacked integrated care management software and care plans, weak practice registry and EHR interoperability, and meager capabilities for patient tracking have all led to significant challenges for primary care teams.
When Dottie Phillips, the healthy 85-year-old mother-in-law of one of us (Amy), broke her elbow, the orthopedist did a wonderful job surgically repairing the injury. Unfortunately, Dottie developed pneumonia in the hospital during her recovery, requiring powerful antibiotics. These led to a subsequent Clostridium difficile (C. diff) infection, which produced debilitating diarrhea. Her prolonged hospital stay caused her to become frail, so she was discharged to a rehab facility with an entirely new care team.
The financial burden of health information exchange (HIE) and the difficulty of wrangling multiple vendors into some sense of interoperability are among the top challenges facing the national health IT infrastructure and the shift towards population health management, according to the eHealth Initiative’s 2014 survey. While Stage 2 of meaningful use has pushed the industry towards wider adoption of Direct messaging and registry reporting, providers have a long road to travel before data exchange becomes simple and seamless across the care continuum.
Primary-care clinics recovered their financial investments in electronic health record (EHR) systems in 10 months on average, a recent study found, in part because EHRs allowed them to see more patients.
Clinic revenue increased with EHR implementation, along with the ratio of active patients per clinical full-time equivalent (FTE) employee, according to the study by researchers at Montreal's McGill University, published in JMIR Medical Informatics.
As a practicing ear, nose and throat specialist in Ahoskie, N.C., Dr. Raghuvir B. Gelot says that little has frustrated him more than the digital record system he installed a few years ago.
The problem: His system, made by one company, cannot share patient records with the local medical center, which uses a program made by another company.
The two companies are quick to deny responsibility, each blaming the other.
This lack of trust called "a huge hurdle' for insurance companies
Physician distrust of payers is a significant impediment to creating value-based reimbursement programs, according to a new survey from global business advisory firm FTI Consulting.
In fact, 41 percent of physicians who do not participate in a value-based relationship point to distrust of payers as the major reason.
Interoperability and technology costs cited as challenges
The ability of accountable care organizations to meet the goals of improving care and lowering costs may be hindered by health IT obstacles suggests a new analysis.
Of the 62 ACOs polled by Premier healthcare alliance this past summer, 88 percent report "significant obstacles" in integrating data from disparate sources; 83 percent say they have a hard time fitting analytics tools into their workflow; and 90 percent say IT costs and a lack of return on investment are key roadblocks to more effective implementation of health IT.
Two lawmakers have introduced a bill (HR 5558) that aims to improve the accountable care organization model in part by allowing ACOs to expand telehealth services, Becker's Hospital Review's "Health IT & CIO Review" reports
Bill Details
The ACO Improvement Act was introduced by Reps. Diane Black (R-Tenn.) and Peter Welch (D-Vt.) (Gregg, "Health IT & CIO Review," Becker's Hospital Review, 9/24).
Many accountable care organizations are struggling with advanced IT functions and interoperability, a survey of 62 ACOs conducted in July and August 2014 by Premier and the eHealth Initiative shows.
“Most ACOs are still at the stage of basic care-coordination capabilities,” said Bryan Bowles, Premier's vice president of population health solution management, Wednesday on a call discussing the survey. “The challenges of blending disparate data have hindered uptake of more advanced functions.”
