{"id":2470,"date":"2014-10-28T05:20:58","date_gmt":"2014-10-27T18:20:58","guid":{"rendered":"http:\/\/blog.panicola.com\/?p=2470"},"modified":"2014-10-28T05:20:58","modified_gmt":"2014-10-27T18:20:58","slug":"drs-dont-care-for-interoperability","status":"publish","type":"post","link":"https:\/\/blog.panicola.com\/?p=2470","title":{"rendered":"Drs don&#8217;t care for interoperability"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p>http:\/\/www.politico.com\/story\/2014\/10\/health-care-data-records-112039.html?hp=l13<\/p>\n<h2>Few motives to fix busted health data<\/h2>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<div class=\"addthis_toolbox addthis_default_style addthis_width\">\n<div class=\"fb-share-button fb_iframe_widget\" data-ref=\".VE6Gpz4vbJE.share-button\" data-type=\"button_count\" data-href=\"http:\/\/www.politico.com\/story\/2014\/10\/health-care-data-records-112039.html\"><img loading=\"lazy\" decoding=\"async\" class=\"border\" title=\"A doctor is shown. | Getty\" src=\"http:\/\/images.politico.com\/global\/2014\/10\/09\/141009_doctors_office_gty_605.jpg\" alt=\"A doctor is shown. | Getty\" width=\"605\" height=\"340\" \/><\/div>\n<\/div>\n<ul>\n<li>\n<div class=\"captioned-image story-art\">\n<div class=\"slideshow-controls\">\n<div class=\"caption close-this\">\n<p>The records are difficult to use, reduce interaction with patients and cost a fortune. | Getty<\/p>\n<p><button class=\"hide-caption\" type=\"button\">Close<\/button><\/div>\n<\/div>\n<\/div>\n<\/li>\n<li class=\"byline\">By <a href=\"http:\/\/www.politico.com\/reporters\/ArthurAllen.html\">ARTHUR ALLEN<\/a> | 10\/20\/14 1:32 PM EDT <span class=\"updated\">Updated: 10\/21\/14 3:00 PM EDT<\/span><\/li>\n<li class=\"story-wrapper\">\n<div class=\"story-text p-content resize\">\n<p>Someday, doctors will have our data at their fingertips and will use it to prevent drug reactions, nip diabetes and cancers in the bud and lengthen our lives while preventing unpleasant and costly hospital stays.<\/p>\n<p>But for most doctors, that free-flowing information highway is a beautiful dream that doesn\u2019t pay the bills.<\/p>\n<p><a class=\"hidden\" href=\"http:\/\/www.politico.com\/story\/2014\/10\/health-care-data-records-112039.html?hp=l13#continue\">Continue Reading<\/a><\/p>\n<div class=\"story-embed\">\n<div id=\"storyControls\" class=\"embed-mod\">\n<div id=\"adjustTextSize\">\n<h4>Text Size<\/h4>\n<ul class=\"adjust-text-size\">\n<li class=\"decrease-font\">&#8211;<\/li>\n<li class=\"increase-font\">+<\/li>\n<li class=\"reset-font\">reset<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div id=\"sidebar_latest\" class=\"embed-mod latest-on-politico\">\n<h4>Latest on POLITICO<\/h4>\n<ul>\n<li><a href=\"http:\/\/www.politico.com\/story\/2014\/10\/poll-mary-landrieu-bill-cassidy-runoff-112223.html?ml=la\">Poll: La. Senate race bound for runoff<\/a><\/li>\n<li><a href=\"http:\/\/www.politico.com\/story\/2014\/10\/janet-napolitano-immigration-112222.html?ml=la\">Napolitano backs immigration executive action<\/a><\/li>\n<li><a href=\"http:\/\/www.politico.com\/story\/2014\/10\/kaci-hickox-release-new-jersey-112221.html?ml=la\">N.J. to release quarantined nurse<\/a><\/li>\n<li><a href=\"http:\/\/www.politico.com\/story\/2014\/10\/samantha-power-ebola-112219.html?ml=la\">Power: U.S. will fight Ebola long-term<\/a><\/li>\n<li><a href=\"http:\/\/www.politico.com\/story\/2014\/10\/lessons-from-leaders-warren-buffett-112218.html?ml=la\">Warren Buffett on leadership<\/a><\/li>\n<li><a href=\"http:\/\/www.politico.com\/story\/2014\/10\/georgia-2014-elections-michelle-nunn-david-perdue-112216.html?ml=la\">Nunn, Perdue bicker over gridlock<\/a><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<p id=\"continue\">Many hospitals don\u2019t have any incentive to improve the clunky $30 billion federal electronic health records program: They still make most of their money by filling beds. Most doctors still get paid through procedures and visits.<\/p>\n<p>(<a href=\"http:\/\/www.politico.com\/story\/2014\/10\/anthony-weiner-fatherhood-politics-111998.html\" target=\"_blank\">Also on POLITICO: Weiner: Done with politics, not life<\/a>)<\/p>\n<p>So a new 10-year plan for fixing the system from the Office of the National Coordinator for Health IT may have a hard time getting off the ground.<\/p>\n<p>\u201cFrom the business perspective, there\u2019s no financial benefit for the majority of hospitals and physicians to be interoperable,\u201d says Steve Waldren, director of the Alliance for eHealth Innovation at the American Academy of Family Physicians. \u201cIf we don\u2019t change the business end of it \u2026 it\u2019s just checking a box.\u201d<\/p>\n<p>Lobbying efforts have yielded a bill that would slow down federal requirements \u2014 and patient-centered care in the process. It could be taken up in the lame-duck session or added to another bill that directly addresses the interoperability issue next year, Hill staff say.<\/p>\n<p>(<a href=\"http:\/\/www.politico.com\/story\/2014\/10\/conservatives-catch-up-as-super-pac-fundraising-explodes-112063.html\" target=\"_blank\">Also on POLITICO: Super PAC fundraising soars for conservatives<\/a>)<\/p>\n<p>\u201cIt may already be too late,\u201d says Thomson Kuhn, a researcher with the American College of Physicians. \u201cShort of some crazy scheme to make a change at the end of the year I just don\u2019t see how we\u2019re going to get what we need. And at that point they\u2019ve killed the program.\u201d<\/p>\n<p>To address that issue, the Office of the National Coordinator\u2019s plan is likely to require EHR vendors to include software interfaces that will make it easier for smooth communication across health care systems. But it may not work unless the economics of medicine shift in a way that forces doctors to require shared information to function.<\/p>\n<p>The HITECH Act of 2009 was designed to let health care professionals use information to improve care and reduce spending and shifting their economic motivation to keeping people healthy, rather than charging for individual treatments.<\/p>\n<p>(<a href=\"http:\/\/www.politico.com\/story\/2014\/10\/nrsc-chair-roger-wicker-dean-heller-112077.html\" target=\"_blank\">Also on POLITICO: Battle begins for NRSC chair<\/a>)<\/p>\n<p>Five years later, most doctors have electronic health records (EHRs) \u2014 that\u2019s where most of the money was spent \u2014 but doctors and nurses are unhappy with the time-consuming clumsiness of the software, much of which wasn\u2019t ready for the medical profession.<\/p>\n<p>The records are difficult to use, reduce interaction with patients and cost a fortune. And for the most part, they haven\u2019t made information sharing easier.<\/p>\n<p>There are some places \u2014 a growing number, in fact \u2014 where interoperability makes business sense. In Massachusetts, for example, many health systems such as Partners HealthCare have more than a third of their patients in value-based care systems built on the state\u2019s network of health information.<\/p>\n<p>(<a href=\"http:\/\/www.politico.com\/story\/2014\/10\/thom-tillis-kay-hagan-north-carolina-112064.html\" target=\"_blank\">Also on POLITICO: Tillis claims &#8216;momentum&#8217; in N.C.<\/a>)<\/p>\n<p>Some patients in these systems already are benefiting from \u201cwrap-around\u201d care that relies on good data, shared among medical professionals.<\/p>\n<p>Such success stories have popped up around the country in tandem with growing consolidation of health networks and the Affordable Care Act-fostered creation of accountable care organizations \u2014 in which doctors are nudged toward focusing on patients, rather than procedures.<\/p>\n<p>In such organizations, information sharing among doctors and hospitals is vital. Shifts in the Medicare payment schemes for doctors next year could also force the medical profession into more reliance on sharing.<\/p>\n<p>\u201cValue-based care may not succeed with good information, but it can\u2019t succeed without it,\u201d says Josh Seidman, a former HHS health IT official who is now a vice president at Avalere Health.<\/p>\n<p>To date, though, most hospitals and provider networks aren\u2019t financially motivated to freely share their patients and data with others. It will cost money to get their computer to share data. Providers, having already spent plenty, aren\u2019t enthusiastic about spending more to meet the demands of the federal incentive program.<\/p>\n<\/div>\n<\/li>\n<li>For some, accepting a penalty will beat buying new software, which they will need to upgrade again for the next stage of the program in a few years, says Rob Tennant of the Medical Group Management Association.<\/li>\n<li>A retreat from the beautiful dream: It\u2019s enough to make some health visionaries sick. One of them, a former official who was involved in creating the incentive program, sniffs that providers have themselves to blame.<\/li>\n<li><a class=\"hidden\" href=\"http:\/\/www.politico.com\/story\/2014\/10\/health-care-data-records-112039_Page2.html#continue\">Continue Reading<\/a><\/li>\n<li class=\"story-embed\">\n<div id=\"storyControls\" class=\"embed-mod\">\n<div id=\"adjustTextSize\">\n<h4>Text Size<\/h4>\n<ul class=\"adjust-text-size\">\n<li class=\"decrease-font\">&#8211;<\/li>\n<li class=\"increase-font\">+<\/li>\n<li class=\"reset-font\">reset<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/li>\n<li id=\"continue\">\u201cA lot of people made bad choices,\u201d he said, speaking on condition of anonymity. \u201cThey didn\u2019t do half as much research before buying their EHRs as they would getting a new car, and they\u2019re paying for it.<\/li>\n<li>\u201cThe people complaining now are the ones at the trough \u2014 the vendors and doctors and hospitals. They gladly took the money, but when it comes time to step up or take the penalty, they say, \u2018Let\u2019s drop out of the program.\u2019 It\u2019s always, \u2018Slow it down, dumb it down, give me money, don\u2019t take anything away.\u2019\u201d<\/li>\n<li>The biggest provider complaint about the current stage of the incentive program is its requirements that doctors share summary-of-care documents and get a percentage of their patients to receive or send health data through secure portals.<\/li>\n<li>They often must shell out tens of thousands of dollars to software vendors to set up portals to transmit data across health care networks or even outside their offices. Their patients aren\u2019t interested in accessing their records, they add \u2014 how can the government penalize them for what their patients won\u2019t do?<\/li>\n<li>Republican members of Congress are skeptical of the federal program\u2019s top-down requirements, and equally incensed by its slow advance.<\/li>\n<li>Rep. Phil Gingrey (R-Ga.) epitomizes this contradiction. This summer he threatened to investigate Epic, the leading EHR vendor, because he said it had taken billions in federal money to create information silos. A month later, he supported a bill put forward by Renee Ellmers (R-N.C.) that would slow down the meaningful use program, giving providers \u2014 and vendors \u2014 more time to learn how to share.<\/li>\n<li>Some Hill staff who track the issue think the answer is to relax federal standards while focusing narrowly on freeing the information \u2014 a position that federal health IT advisory committees share.<\/li>\n<li>\u201cIt\u2019s hard to argue with physicians who say their systems aren\u2019t ready, so they shouldn\u2019t be penalized,\u201d said a Hill staffer. \u201cBut the administration has to make this happen. \u2026 Every year we don\u2019t have interoperability, public health issues go unaddressed and that\u2019s unfortunate.\u201d<\/li>\n<li>A parade of witnesses appearing before the House Energy and Commerce Committee this year as part of its 21st Century Cures Initiative have stressed the importance of free-flowing health data \u2014 not only for patient care but also for research leading to cures.<\/li>\n<li>\u201cIf we had a truly networked health care system, it would allow us to gather data on patients treated with drugs on and off label to see what kinds of adverse events are occurring,\u201d said William Hanlon of drug testing company Covance, in testimony last month. \u201cIt could have huge benefits for clinical trials.\u201d<\/li>\n<li>Energy and Commerce staff say that information sharing will be part of legislation they expect to put out early next year.<\/li>\n<li>The Health and Human Services Department is feeling pressure from Congress \u2014 in multiple directions. CMS has delayed the incentive program twice already in response to provider unhappiness. At the same time, ONC has taken a harder line on enforcing interoperability.<\/li>\n<li>Earlier this month, HHS official Kelly Cronin noted that some EHR vendors were charging up to $20,000 to create computer interfaces for users to access out-of-network laboratories. She suggested her office might pass along such information to the Federal Trade Commission, to investigate as obstructions to free trade.<\/li>\n<li>HHS\u2019s health IT coordinator, Karen DeSalvo, has indicated that her agency may toughen its stance.<\/li>\n<li>\u201c[The Office of the National Coordinator] believes the market has not solved this problem on behalf of the American people,\u201d she said in an interview. \u201cPatient data is a public good so there has to be a public involvement in making sure everyone \u2026 has the data available in an appropriate way.\u201d<\/li>\n<li><em>The version of this story has corrected the spelling of Thomson Kuhn\u2019s name.<\/em><\/li>\n<li>\nRead more: <a href=\"http:\/\/www.politico.com\/story\/2014\/10\/health-care-data-records-112039.html#ixzz3HN1pB9eO\">http:\/\/www.politico.com\/story\/2014\/10\/health-care-data-records-112039.html#ixzz3HN1pB9eO<\/a><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; http:\/\/www.politico.com\/story\/2014\/10\/health-care-data-records-112039.html?hp=l13 Few motives to fix busted health data &nbsp; &nbsp; The records are difficult to use, reduce interaction with patients and cost a fortune. | Getty Close By ARTHUR ALLEN | 10\/20\/14 1:32 PM EDT Updated: 10\/21\/14 3:00 PM EDT Someday, doctors will have our data at their fingertips and will use it to &hellip; <a href=\"https:\/\/blog.panicola.com\/?p=2470\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Drs don&#8217;t care for interoperability<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,9,22,3],"tags":[],"class_list":["post-2470","post","type-post","status-publish","format-standard","hentry","category-data-saving-lives","category-healthcare","category-policy","category-rapid-learning-health-systems"],"_links":{"self":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/2470","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2470"}],"version-history":[{"count":1,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/2470\/revisions"}],"predecessor-version":[{"id":2471,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/2470\/revisions\/2471"}],"wp:attachment":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2470"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2470"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2470"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}