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4/11/2011
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HHS Pushes Private Sector To Fix Healthcare Problems

Federal health IT official says government's job is to lay the foundation for business innovations that will reduce waste and improve public health.

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Perhaps to fight conservative critics or perhaps because it's truly what they want, federal health IT officials continue to call on the private sector to solve some of healthcare's most vexing problems.

"We firmly believe that the private marketplace has some of the key answers," Dr. Thomas Tsang, medical director for meaningful use and quality in the Office of the National Coordinator for Health Information Technology (ONC), said Wednesday at a health IT meeting in Atlanta hosted by the New York-based Institute for Health Technology Transformation.

His comments echo those of Todd Park, CTO for the Department of Health and Human Services (HHS). At last month's South by Southwest Interactive event in Austin, Texas, Park told an interviewer that it was not the government's job to innovate but rather to lay the foundation for the private sector to innovate.

"What we're trying to do is leverage some existing programs," said Tsang, who previously led implementation of electronic health records (EHRs) and application of health IT for disease management at a community health center in New York City.

Why? Because healthcare spending accounts for 21% of the Obama administration's proposed 2012 budget, somewhere in the range of $800 billion. "About one-third of that is complete waste," Tsang said.

Tsang talked of some of the "open data" initiatives championed by Park and the federal government's CTO, Aneesh Chopra, to achieve what Park has called "data liberación" by providing software developers with access to vast storehouses of healthcare information that's never been fully analyzed. "I think data analytics is going to be huge," said Tsang.

He also highlighted the Standards and Interoperability Framework, the pet project of Dr. Doug Fridsma, director of the ONC office of standards and interoperability. The latter is an effort to convene a wide range of industry stakeholders to harmonize standards and share best practices with the goal of improving electronic interoperability of healthcare data.

In the realm of regulations, Tsang said that HHS has tried to create some similarities between the "meaningful use" EHR incentive program and other rules to make it easier for healthcare entities to meet the standards. Of the 65 quality measures in the recently published proposal for accountable care organizations, 22 overlap with Stage 1 meaningful use, according to Tsang. "What you're seeing is alignment across a lot of federal programs," Tsang said.

He added that there's also about an 80% "concordance" between meaningful use and the National Committee for Quality Assurance's 2011 model for the patient-centered medical home. "If you achieve meaningful use, you're almost achieving patient-centered medical home recognition," Tsang said.

Tsang told the Atlanta gathering of health IT professionals that ONC could really use their help in carrying out what the administration is now calling the National Strategy for Quality -- essentially the "triple aim" of Centers for Medicare and Medicaid Services administrator Dr. Donald Berwick. (Berwick has long said that healthcare should improve population health, provide better care for individuals, and lower costs.)

Tsang suggested that health IT focus on risk assessment, modifiable patient behaviors to help increase efficiencies and reduce hospital readmissions, and developing strategies for caring for patients with dual Medicare and Medicaid eligibility. "How are you going to take care of patients with five or more chronic conditions?" Tsang asked. "How do you put all these pieces together?"

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