Hargan: Value-based payment impossible without interoperable health IT

Interoperability is critical in order to successfully transition away from fee-for-service, says HHS deputy secretary.

The healthcare industry will not be able to move to a system that rewards value without achieving health IT interoperability, according to Health and Human Services Deputy Secretary Eric Hargan.

“Advancing health IT is inextricably bound up with what may be the most important priority that HHS has today, which is transforming our healthcare system into one that pays for value,” said Hargan in a keynote address on Thursday during the opening session of the ONC Annual Meeting in Washington.

According to Hargan, health IT interoperability is critical to the industry successfully transitioning from fee-for-service to value-based payment.

“It is actually impossible to move to a future health system—the one that we need, one that pays for procedures rather than sickness—without a truly interoperable health IT system,” he added.

Hargan said HHS has as its goal an interoperable healthcare IT system that “helps patients and providers make easy use of their health data.”

“We must transform healthcare through the use of technology—the way other industries have been able to do,” added Lisa Lewis, deputy national coordinator for operations at ONC. “Unlike other industries, it is life or death for us. And, I know that adds a lot of complications. But, doesn’t that make it even more critical that we make it happen—that we work through the complicated infrastructure of policy, technology, and business drivers that can make it hard for us to achieve interoperability.”

ONC released a data brief this week showing that four in 10 acute care hospitals in 2017 could electronically send, receive, find and integrate patient health information from outside providers or sources—up from three in 10 in 2016.

Nonetheless, ONC’s report concluded that significant challenges remain that are impeding the progress toward nationwide interoperability.

“Hospitals’ limited ability to integrate data, difficulty locating provider addresses, and exchange partners’ EHR systems lacking the capability to receive health information stand out as significant barriers to interoperable exchange,” states the report. “Additionally, small, rural, and CAHs experience these barriers at significantly higher rates which result in a sizable gap in interoperable exchange among different hospital types.”

In addition, ONC noted that “more than half of hospitals report challenges exchanging health information across different vendor platforms” and that there are “providers with whom hospitals share patients that don’t typically exchange data with the hospital.”

In fact, nearly six in 10 hospitals last year reported challenges exchanging patient health information across different vendor platforms—up from five in 10 in 2016.

“The path forward is not to micromanage the how of health IT—but, just to lay out the what,” Hargan told the audience. “How all of that happens is really up to you. That is part of what the private sector brings to the table—which is the understanding of how we get where we need to go.”

At the same time, he emphasized that HHS is “not afraid to take bold steps in overhauling outdated rules or incentives that may be getting in the way of providers making the best use of health IT.”

Earlier this week, HHS released a draft strategy to reduce the administrative and regulatory burdens on clinicians caused by the use of health IT and EHRs.

Also See: HHS pledges to reduce health IT regulatory burdens on clinicians

The HHS strategy and recommendations for burden reduction are described by the agency as a “range of incremental changes to allow clinicians to enjoy the benefits of greater interoperability while producing benefits for patients and the healthcare system overall.”

“We have already moved to focus our EHR incentives on interoperability and there are other important regulatory steps that remain to come,” Hargan said.

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