On November 29-30, 2018, Health IT policymakers and implementers met in DC for the Annual ONC Meeting. As always, the agenda was full to the brim with discussions on the state-of-the-health IT industry.
Interoperability and the future of 2015 Edition CEHRT were central themes, but the agenda content reveals just how far-reaching ONC’s influence reaches – and by extension, the use of health IT systems and applications. Sessions tackled subjects as wide-ranging as care coordination, interoperability strategies, APIs, disaster response and opioid prescribing.
Jeff Robbins, Dynamic Health IT President, attended the meeting. His enthusiastic takeaway was that the conference was very beneficial, providing a survey trends in health IT today and learn about innovative approaches to our most pressing challenges. While it’s impossible to attend all sessions (or even to summarize them in a single blog post), we’ll review a few highlights.
The breakout session “Improving Opioid Prescribing through Electronic Clinical Decision Support Tools” focused on the solving the challenges posed by the Opioid Epidemic in the Prescription Drug Monitoring Program (PDMP). As part of monitoring, prescribing physicians can be securely notified of non-fatal overdose episodes, but this is currently uncommon. By connecting providers to PDMPs more widely, we can ensure that they have timely information that can limit drug-seeking, modulate prescription behavior and point to important connections to limit the spread of opioid abuse.
While we acknowledge the depth of the challenges facing the industry currently – particularly with respect to interoperability – there were plenty of success stories in evidence. DHIT was impressed by case studies showing enthusiastic adoption of the HL7 Fast Healthcare Interoperability Resource (FHIR) data standard for provider-payer data exchange. A private sector-led initiative — the Da Vinci Project — has progressed quickly enough to enlist government sponsorship from the ONC and then spawned the P2 FHIR Taskforce. The task force is supporting FHIR development efforts and turning its focus to challenges preventing adoption.
The “FHIR Implementation and Transition Planning” session was another opportunity to discuss EHR vendor Application Programming Interfaces (APIs). The 21st Century Cures Act calls for the development of APIs to promote data-sharing and the ONC 2015 Edition Test Method includes three measures (g7, g8, g9) encompassing patient data APIs – though neither explicitly mandate FHIR. During the Q&A session, Cerner and Epic were in the hot seat with application and personal health record (PHR) developers seeking broader access to their FHIR APIs.
On Friday, a lively panel discussion on “Data and Value-Based Care” was held. Economist Mark Pauly discussed the proverbial elephant in the room – a subject that is often avoided: cost/benefit of healthcare and the need to set dollar limits on individual healthcare plan coverage. Mark posed the hypothetical of whether there should be marginal dollar limits for coverage.
Finally, it’s worth reflecting on the future of ONC’s latest health IT test method: 2015 Edition CEHRT. With funding in questions and transition in both programs, Certification and Meaningful Use have both seen grave pronouncements within the last few years. But 2015 Edition CEHRT is still required in 2019 for providers reporting MIPS. And for those providers targeting the “end-to-end bonus” for eCQM reporting, that must be done in conjunction with a system that meets 2015 Edition CEHRT.
Our challenges – and the policy initiatives designed to meet them – aren’t going anywhere.
