Even if you're still struggling to comply with Stage 1 Meaningful Use requirements of the HITECH Act's $27 billion financial incentive program, there's no time like the present to be looking ahead to Stages 2 and 3. And while the criteria for the next two stages won't be finalized by the federal government for at least another year or two, better get ready for what's in store. It may be a painful and bumpy ride.
That's the advice given earlier this week at the InformationWeek Healthcare IT Leadership Forum in New York City by speaker Dr. Neil Calman, founder and CEO of the Institute for Family Health, which runs 16 community health centers and three homeless healthcare sites in Manhattan, the Bronx, and Hudson Valley.
Calman should know. He's also a member of the Health IT Policy Committee that's working with the Office of National Coordinator for Health IT on the upcoming Meaningful Use Stages 2 and 3. Calman wasn't disclosing information that's top secret. But in case you're not plugged into the HIT Policy's Committee's public meetings and teleconferences, you might not be aware of what's been discussed for the upcoming stages of Meaningful Use.
Calman sees clearly where things are going, both in terms of the nascent Stage 2 and 3 regulations, and in terms of big market trends that are propelling changes ahead for healthcare and health IT.
For starters, people tend to forget that compliance with the HITECH Act's $27 billion MU financial incentive programs is voluntary. You don't have to go after the bonuses. But remember that eventually you can be penalized with reduced payments from the Centers of Medicare and Medicaid Services (CMS) if you don't demonstrate Meaningful Use.
With or without the HITECH Act, Calman thinks the healthcare industry would've been headed in the direction of e-health records and digitization anyhow. Early-adopter organizations like Calman's have been using e-health records for more than 10 years. And isn't every other industry computerized and Web-enabled in the 21st century? Don't customers across other sectors, like financial services, expect to access their relevant information via the Internet? Why should healthcare be any different?
However, without the multi-billion-dollar carrot from the feds, digital transformation of the health industry would've just continued to move at a snail's pace and, in the meantime "people are dying … and people are being hurt" by medical mistakes and other lapses in quality care and safety that could've been prevented with health IT, he said.
So, that brings us to some of the big megatrends that Calman predicts. Some of these trends will be accelerated by the HITECH Act's likely requirements in Stages 2 and 3, but are also happening due to larger healthcare reform and market dynamics.
One key trend to look for is that providers will need to become much more public in their reporting. It won't be good enough to submit quality reporting (including measures required for MU compliance) to CMS. Those reports will eventually become public, just as the Dept. of Health and Human Services recently began reporting privacy and security data breach incidents on its new HIPAA violation website. "Open access and public disclosure to outcome data … nothing forces us to improve what we do as when we have to show it others," said Calman.
Another megatrend is healthcare providers who "brag about how fantastic they are" will be forced to back up their bravado by "being tied to the health outcomes of the communities that they serve," he said.
"I can tell you that one of the big tragedies in New York that are replicated across the country is that we see these huge academic medical centers sitting in the poorest neighborhoods with the highest rates of hospital readmissions for ambulatory-sensitive conditions--highest rates of hospitalizations for asthma, highest rates of amputations due to diabetes," and other problems related to disparities in care, he said.
Healthcare providers will be held responsible for "not just the people who walk in the door," but for the health of the communities in which they serve, he said. There will be increased accountability for providers to show not only outcomes but also impact, he said.