Dr. Blumenthal Presents ONC Vision at HIT Symposium
Dr. Blumenthal Presents ONC Vision
at HIT Symposium
Healthcare reform is getting a mind-bending boost from the American Recovery and Reinvestment Act, with as much as $46 billion being directed toward Health Information Technology. Managing this effort is the Office of the National Coordinator for HIT, Dept. of Health and Human Services, or ‘ONC’ for short. The ONC is spoken of in hushed tones, befitting an organization with such enormous impact, so I was especially interested to hear its Director, Dr. David Blumenthal, speak at the recent HIT Symposium at MIT (June 30 – July 2).
Dr. Blumenthal put a remarkably human face on the ONC, coming across as thoughtful, approachable, a soft-spoken leader on a mission to improve healthcare. While our healthcare system challenges may seem unassailable, Dr. Blumenthal seemed unfazed, saying we just have to start: we can make a difference, and the provisions of ARRA offer a unique opportunity for “discontinuous change.”
The ONC’s vision is to bring our entire healthcare delivery infrastructure up to a new level, through the universal implementation of health information technology that will allow information to flow freely between patients, providers and payers. This will enable a new generation of applications that will enable improved clinical decisonmaking, patient-provider communication, and empower patients to self-advocate utilizing their own personal health records.
By 2015, the goal is to have 90% of providers and 70% of hospitals up and running with electronic health records that enable “meaningful use” of health information. Dr. Blumenthal emphasized that this will be a sea change, establishing a new level of medical professionalism. Today’s physicians would not dream of practicing without a stethoscope or examining table. In the future, they will not consider practicing without an electronic health record (EHR).
“Meaningful use” is the heart of the ONC program, setting goals for healthcare, not simply technology adoption. Proposed goals are presented in the ONC HIT Policy Committee’s June 16 recommendations (see Health IT Policy Committee). These present an “achievable vision for 2015” that includes reducing preventable medication errors by 50%, preventing a million heart attacks and strokes, and reducing preventable hospitalizations and readmissions by 50%. (Defining which EHR systems will qualify for financial incentives is the role of the ONC’s HIT Standards Committee – see HIT Standards Committee).
The ONC’s budget of $2 billion will fund the formation of health information exchanges, provision of EHR grants and loans, and perhaps most important, technical support for small provider groups and hospitals implementing new EHR systems. Dr. Blumenthal noted that 70% of clinical visits are to doctors with five or fewer physicians, small organizations that will be most challenged to implement new IT systems. The ONC has proposed forming HIT Regional Extension Centers to provide direct technical assistance, from system planning through implementation. ONC’s own budget is unlikely to fund all needed support; HIT vendors may be asked to help shoulder this burden.
Getting physicians to get behind and implement EHRs may be the program’s greatest challenge. The maximum reimbursement for EHR investment will be $44K per physician practice, less than the projected cost of implementing a new system. IT support will help, but it will take a real belief in the ultimate value of the EHR to push physicians over the top. (Note that the number of physicians that take advantage of the incentive program will determine the total program value; Dr. Blumenthal quoted Congressional estimates that earned incentives and direct payments, funded in part by penalties and CMS savings, will total $44 billion).
Physicians, hospitals, and the rest of us are being asked to believe that this fundamental jump-shift in our healthcare infrastructure is worth the investment. As Dr. Blumenthal noted, we are now on a “forced march” to meet the statutory requirements set by ARRA. We need to move forward, on faith that we will figure things out as we go.
More information: Many presentations from the ‘HIT Symposium at MIT’ are available online. View the agenda to find them: http://www.hitsymposium.com/
Jeffrey Scott is Principal, Emergent Business Development