National HIT coordinator Mostashari calls on clinicians and patients to demand more data at point of care. This will help drive development of health information exchanges, he says.
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National health IT coordinator Dr. Farzad Mostashari is challenging clinicians and patients alike to create demand for health information exchange by asking that pertinent information be available whenever and wherever healthcare decisions need to be made.
"No investment in standards or infrastructure for information exchange will rapidly mobilize information sharing if the underlying demand for the shared information is low. Demand for information is the business driver for health information exchange," Mostashari and colleagues in the Office of the National Coordinator for Health Information Technology (ONC) wrote in an article published in Health Affairs that outlined a new national HIE strategy.
"Sharing information to coordinate care--where information is sent and received between providers, such as a referral from a physician to a specialist--can build demand for, and trust required to support, other exchange models that involve aggregating and finding patient data," ONC officials added. "The goal of health information exchange is for information to follow patients, wherever and whenever they seek care, in a private and secure manner so that teams of doctors, nurses, and care managers can provide coordinated, effective, and efficient care."
The office also wants to help providers meet requirements for Meaningful Use of electronic health records (EHRs). Proposed rules for Stage 2 of the federal EHR incentive program call for more standards-based interoperability and patient engagement than the current Stage 1. (The proposal was officially published in the Federal Register Wednesday, triggering a 60-day public comment period.)
Mostashari took the message on the road Friday, appearing with stakeholders representing physicians, payers, employers, consumers, and California's state government, to try to drum up support for the plan at the Los Angeles headquarters of the California Association of Physician Groups. The event was intended, according to Howard A. Kahn, CEO of safety-net health insurer L.A. Care Health Plan, to raise awareness of HIEs in the local market and help organizations and companies across the state prepare for healthcare reform.
Kahn, who participated in the press event, told InformationWeek Healthcare via telephone that Mostashari discussed the shift of payment incentives away from fee-for-service to a system that rewards positive outcomes.
"The more information that providers have about their patients and their patients' health, the more effective they can be in providing care," said Kahn. From the perspective of the health plan, HIE "is absolutely central" to winning the trust of physicians in a world of bundled payments and accountable care, according to Kahn.
"Every provider needs to have the fundamental technology in their practice to connect to the HIE," added Mary Franz, executive director of HITEC-LA, the federally funded regional extension center for Los Angeles County, charged with helping providers adopt EHRs and achieve Meaningful Use. Information must "flow directly to the EHR" so providers do not have to look in multiple locations to find patient-specific data about care delivered elsewhere, she added.
In the Health Affairs paper, ONC said transitions of care occur in more than 40% of all outpatient visits, and are most common among those with chronic diseases and other complex medical conditions--exactly the people who stand to benefit the most from a system of interoperable EHRs.
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