HITECH Update: Keeping the Patient at the Center of All We Do

During the session entitled “HITECH Update: Keeping the Patient at the Center of All We Do,” Judy Murphy, RN, the deputy national coordinator for programs and policy in the Office of the National Coordinator for Health IT in Washington, DC, updated participants regarding the efforts under way under the Health Information Technology for Economic and Clinical Health (HITECH) Act to promote improvement in the quality of healthcare through health information technology (HIT).

In particular, Murphy talked about the 3 stages of Meaningful Use and the standards established by the Centers for Medicare & Medicaid Services (CMS) that govern the use of electronic health records (EHRs). Under HITECH, eligible healthcare professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt certified EHR technology and use it to achieve specified objectives.

Murphy began her discussion by noting that the percentage of eligible professionals and hospitals who have currently received EHR incentive payments by completing Stage 1 (focused on data capture and sharing) of the Meaningful Use initiative is pretty good, overall. As of April 2013, 56% of eligible professionals have received payment; there has been a dramatic increase over the last couple of months. With regard to hospitals, 77% of hospitals have received payment. She emphasized that the challenge now is to access and use EHRs to help make the necessary changes to a type of healthcare delivery that is increasingly focused on value and outcomes.

She emphasized that Stage 2 is a broader implementation of Stage 1 and includes accessing and using EHRs to eventually improve outcomes (Stage 3). Stage 2 will begin on October 1, 2013, and will not be delayed as some have expected. She emphasized that any hospital that has attested to Stage 1 will be expected to attest to Stage 2 between October 1, 2013, and September 2014.

Under Stage 2, hospitals will be required to focus on issues of interoperability (eg, e-prescribing for both ambulatory and inpatient discharge) and transition of care summary exchange that includes both the need to create and transmit information from the EHR and receive and incorporate information into the EHR.

Furthermore, there will be a stronger focus on engaging patients in their own healthcare by providing them the ability to view, download, and transmit their health data to a third party. According to Murphy, this is a big deal as it is part of changing the entire culture of medicine. She emphasized that hospitals should use Stage 2 as a launching pad to help make the culture shift to a more modernized healthcare system that places the patient at the center. To help healthcare professionals and hospitals learn about issues related to interoperability, she steered participants to the HealthIT website (http://www.healthit.gov/). The website includes resources and training on the basics of interoperability.

Murphy also explained that a particular focus in Stage 2 will be efforts to get patients engaged in their own healthcare by facilitating access to health information (ie, through reminders for preventive/follow-up care, educational resources, and online access to personal health information), encouraging the patient to act by making it easier to use HIT, and facilitating a change in attitude to encourage patients to be more engaged in their health. A couple of resources she provided to help make it easier for patients to act and use their health IT include the Surgeons General’s Healthy Apps Challenge website (http://sghealthyapps.challenge.gov) and the Challenge.gov website (http://challenge.gov).

Murphy concluded her discussion with a brief explanation of the future challenges, emphasizing that the efforts in Stage 2 to access the information that has been captured and shared in Stage 1 are all geared toward eventually improving outcomes in Stage 3.

Murphy said that the goal is to transform healthcare and move toward a model of accountable care organizations that focus on improving population health, provide enhanced access and continuity of care, use data to improve delivery and outcomes, get the patient engaged, provide a team-based approach to care, use registries to manage patient populations, and ensure privacy and security protections.