Why the CMS push for interoperability could make an impact
Initiatives reinforce the growing role of interoperable systems as well as the emphasis on more efficient and more patient-centric care.
The Centers for Medicare and Medicaid Services in July announced an overhaul to the requirements surrounding the exchange of electronic health information. Beyond interoperability, CMS is also focusing on telecommunications technology with planned reimbursements for virtual care.
The proposed Calendar Year 2019 Physician Fee Schedule also supports items such as brief, non face-to-face appointments via telecommunications, clinician evaluation of patient-submitted photos and expanded Medicare-covered telehealth services, all geared toward driving further innovation in patient care.
These initiatives reinforce the growing role of interoperable systems, as well as the emphasis on more efficient and more patient-centric care. What CMS is proposing are changes to boost digital information sharing through improved electronic health records (EHR) interoperability and patient access to health information.
Better interoperability means better sharing of information on individual patients across health ecosystems. That means every care constituent, including primary care physicians, specialists, radiologists, surgeons and more, can access a single universal patient record to collaborate more effectively.
It also means that clinicians are liberated from excessive documentation tasks and can devote more energy to patients. Speaking of patients, with a universal record accessible from almost anywhere, patients can track their own health to improve engagement and adherence to care plans.
With the ability to analyze health data across all patients with a common condition, the entire population can benefit from improved interoperability. Add to this the value of a newly efficient system of care with streamlined billing, and the case for interoperability becomes clear.
This effort from CMS is just another indication that if we want true interoperability, then we need to shift our thinking about how to nurture the development of EHR systems. We need to move away from restricted control of EHRs and enable them to become the powerful tools they were meant to be. This seems to be the direction that the new initiative from CMS is taking.
Within the CY 2019 Physician Fee Schedule provided by CMS, there are provisions for more flexible documentation requirements for Evaluation and Management (E&M) office visits. Interestingly, CMS estimates that removing burdensome and unnecessary paperwork through its proposal would save clinicians an estimated 51 hours per year, if 40 percent of their patients are in Medicare. Reducing documentation requirements, particularly for outpatient procedures, will liberate physicians to focus more on care coordination and preventive care.
CMS seems to be making a solid effort with this proposal, but we’ll have to wait and see the success of its execution. Many EHR companies have kept their technology locked away in proprietary silos. CMS efforts need to break these walls down with the right incentives to encourage vendors to move to open platforms.
Two efforts toward that goal, include a rework of the Merit-based Incentive Management System (MIPS) to boost EHR interoperability and patient access; and requiring MIPS-eligible clinicians to use recent (2015) edition certified EHRs at the start of the 2019 MIPS period.
One example of a major initiative already underway to enable greater interoperability is an open source platform being developed by Partners Healthcare. This platform will enable improved clinical care by lowering the knowledge exchange barriers across providers and germinate the next generation of clinical support applications.
This digital platform will be based on Substitutable Medical Applications & Reusable Technologies (SMART). SMART is an open-standards technology that will combine with Fast Healthcare Interoperability Resources (FHIR) to empower provider systems nationwide with the ability to rapidly and cost effectively deploy best practices in clinical care.
Other previously existing networks are also expanding interoperability at a solid growth rate. The Surescripts Interoperability Network increased its secure health data exchange transactions by 26 percent in 2017. The number of healthcare professionals in the network grew by 13 percent to 1.47 million, which translated into 1.74 billion electronic prescriptions and 25.9 million direct clinical messages in that same year.
Also, healthcare alliance DirectTrust reported 47.8 million health data exchange transactions in the first quarter of this year. This is a 90 percent increase, compared with the first quarter of 2017. The alliance also stated that the sharing of public health information (PHI) increased by 17 percent to almost 1.7 million, and that the DirectTrust network now includes 117 healthcare organizations.
As changes to CMS requirements indicate, uniting healthcare providers into one, seamless system of care, not only frees them up to focus more on the patient and less on paperwork, but it empowers patients to take an active role in their healthcare. Thanks to advanced technologies and data sources we have the information that is required, we just need to make that information more easily accessible to everyone in the continuum of care.
The proposed Calendar Year 2019 Physician Fee Schedule also supports items such as brief, non face-to-face appointments via telecommunications, clinician evaluation of patient-submitted photos and expanded Medicare-covered telehealth services, all geared toward driving further innovation in patient care.
These initiatives reinforce the growing role of interoperable systems, as well as the emphasis on more efficient and more patient-centric care. What CMS is proposing are changes to boost digital information sharing through improved electronic health records (EHR) interoperability and patient access to health information.
Better interoperability means better sharing of information on individual patients across health ecosystems. That means every care constituent, including primary care physicians, specialists, radiologists, surgeons and more, can access a single universal patient record to collaborate more effectively.It also means that clinicians are liberated from excessive documentation tasks and can devote more energy to patients. Speaking of patients, with a universal record accessible from almost anywhere, patients can track their own health to improve engagement and adherence to care plans.
With the ability to analyze health data across all patients with a common condition, the entire population can benefit from improved interoperability. Add to this the value of a newly efficient system of care with streamlined billing, and the case for interoperability becomes clear.
This effort from CMS is just another indication that if we want true interoperability, then we need to shift our thinking about how to nurture the development of EHR systems. We need to move away from restricted control of EHRs and enable them to become the powerful tools they were meant to be. This seems to be the direction that the new initiative from CMS is taking.
Within the CY 2019 Physician Fee Schedule provided by CMS, there are provisions for more flexible documentation requirements for Evaluation and Management (E&M) office visits. Interestingly, CMS estimates that removing burdensome and unnecessary paperwork through its proposal would save clinicians an estimated 51 hours per year, if 40 percent of their patients are in Medicare. Reducing documentation requirements, particularly for outpatient procedures, will liberate physicians to focus more on care coordination and preventive care.
CMS seems to be making a solid effort with this proposal, but we’ll have to wait and see the success of its execution. Many EHR companies have kept their technology locked away in proprietary silos. CMS efforts need to break these walls down with the right incentives to encourage vendors to move to open platforms.
Two efforts toward that goal, include a rework of the Merit-based Incentive Management System (MIPS) to boost EHR interoperability and patient access; and requiring MIPS-eligible clinicians to use recent (2015) edition certified EHRs at the start of the 2019 MIPS period.
One example of a major initiative already underway to enable greater interoperability is an open source platform being developed by Partners Healthcare. This platform will enable improved clinical care by lowering the knowledge exchange barriers across providers and germinate the next generation of clinical support applications.
This digital platform will be based on Substitutable Medical Applications & Reusable Technologies (SMART). SMART is an open-standards technology that will combine with Fast Healthcare Interoperability Resources (FHIR) to empower provider systems nationwide with the ability to rapidly and cost effectively deploy best practices in clinical care.
Other previously existing networks are also expanding interoperability at a solid growth rate. The Surescripts Interoperability Network increased its secure health data exchange transactions by 26 percent in 2017. The number of healthcare professionals in the network grew by 13 percent to 1.47 million, which translated into 1.74 billion electronic prescriptions and 25.9 million direct clinical messages in that same year.
Also, healthcare alliance DirectTrust reported 47.8 million health data exchange transactions in the first quarter of this year. This is a 90 percent increase, compared with the first quarter of 2017. The alliance also stated that the sharing of public health information (PHI) increased by 17 percent to almost 1.7 million, and that the DirectTrust network now includes 117 healthcare organizations.
As changes to CMS requirements indicate, uniting healthcare providers into one, seamless system of care, not only frees them up to focus more on the patient and less on paperwork, but it empowers patients to take an active role in their healthcare. Thanks to advanced technologies and data sources we have the information that is required, we just need to make that information more easily accessible to everyone in the continuum of care.
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