Health Information Technology and the Road to Reform

Health information technology (HIT) was the focus of a discussion led by Farzad Mostashari, MD, visiting fellow, Brookings Institution, former national coordinator for HIT, US Department of Health and Human Services. In his Managed Markets Summit 2014 keynote address, “Health IT and Reform: The Road to Right Care,” Dr Mostashari touched upon the obstacles and shortcomings in our nation's healthcare landscape, and asserted that more prominent usage of HIT would help to alleviate fiscal concerns and affect better outcomes in patient care. By examining what has been done thus far in terms of HIT, Dr Mostashari substantiated his call for multifaceted reform.

When it comes to healthcare, as Dr Mostashari put it, you get what you pay for. “So, what do we get?” We get lots of heads and beds,” he added. The message was clear: we need new payment models in healthcare.

What will compel providers to care about total cost and quality of healthcare delivery, and the patient experience? If healthcare organizations don’t have the tools and training to move away from a fee-for-service system, Dr Mostashari warned, a new healthcare system is unfeasible.

Dr Mostashari attributes the lag in healthcare advancement to a vague understanding amongst providers about "what matters" in healthcare delivery. Without the proper tools in place, he asserts, providers cannot adequately measure basic markers of care such as blood pressure rates and smoking cessation. It is this lack of measurable results that leaves providers unable to attest to their importance.

"We need data," Dr Mostashari continued. He pointed to the results of a multibillion dollar stimulus given to providers by the Office of the National Coordinator to help them integrate electronic health records (EHRs) into their practices. According to Dr Mostashari, in a 4-year span, the rate of providers ordering through computers climbed from 27% to 72%, while e-prescribing increased from 4% to 60%. With the success of EHR integration substantiated, Dr Mostashari urged providers to consider the utilization of HIT “a standard of care."

However, the utilization of HIT resources still needs to be optimized, and meet the demands of the new payment policies for providers. It is this optimization, Dr Mostashari believes, that will allow providers to easily transition into a new results-conscious healthcare system, and thus redirect their focus to the total quality and cost of healthcare delivery.

Dr Mostashari also touched upon the importance of patient engagement, and patient access to clinicians' notes. By highlighting the new OpenNotes program, Dr Mostashari showed that patients and their caregivers are more than willing to participate in the healthcare system, which would result in better adherence and better communication between patients and their doctors. It is for this reason that he referred to patients as healthcare's most important resource, and their engagement is crucial to the transition into a new healthcare system.