HHS nominee sees potential of big data, pitfalls of EHRs

Alex Azar, Trump’s pick to lead the agency, sees health IT as both benefit and burden to healthcare providers.

President Donald Trump’s nominee to head the Department of Health and Human Services contends that by harnessing the power of big data and predictive analytics, the healthcare industry can be made more efficient and lead to better patient outcomes.

Alex Azar told a Senate committee on Wednesday that Medicare must “shift the focus in our healthcare system from paying for procedures and sickness to paying for health and outcomes.”

Azar testified that if he is confirmed to serve as HHS secretary, one of his four critical priorities at the agency will be to “better channel the power of health information technology and leverage what is best in our programs—and in the private competitive marketplace—to ensure the individual patient is the center of decision-making, and his or her needs are being met with greater transparency and accountability.”

Also See: Trump picks former Lilly drug executive as HHS secretary

A former executive at pharmaceutical giant Eli Lilly & Co., Azar said in his testimony that “leading the incredible resources of the department require innovating, never being satisfied with the status quo, and anticipating and preparing for the future.”

However, when it comes to making changes to current HHS regulations, Sen. Lamar Alexander (R-Tenn.), chairman of the Senate health committee, told Azar that the Centers for Medicare and Medicaid Services needs to address its Meaningful Use Stage 3 rule.

“I had urged the previous administration to delay Meaningful Use 3 because it was implementing it at a time when it was also changing the way doctors and providers are paid,” said Alexander, who added that it was a mistake for CMS to rush ahead with a final rule against the advice of some of the nation’s leading medical institutions. “I thought it would be wise to slow that down and get it right and build confidence among the physicians and other providers.”

Pointing to the shortcomings of electronic health records and the widespread dissatisfaction of doctors who use the systems, Alexander referenced an American Medical Association study which found that physicians believe they are “spending 50 or 60 percent of their time on documentation.”

Alexander told Azar that a good approach to address the burdens of excessive EHR documentation “might be for the (HHS) secretary to work with the doctors in Medicare” to set a goal of reducing the amount of time providers spend documenting on electronic records systems.

“On the regulatory burden or just the burden of electronic health records with physicians, that would be my style of how to work—the affected individuals they know what’s wrong, they know what’s happening, and get the input from them to see if there are appropriate changes that can be made,” responded Azar.

The lack of health IT interoperability is another serious challenge confronting the healthcare industry, Alexander told Azar. “It’s a big mess still,” the senator claimed. “Even at a sophisticated hospital, if you want to take your own medical records to some other place, the best thing you can do is Xerox them yourself, put them in your briefcase, carrying them over and hand them to the next doctor.”

Azar replied that in terms of the lack of interoperability, “it is ridiculous if we have a system now where you have to collect your paper records to go to a different facility.” He added that the inability of EHR systems to interoperate is “a betrayal of the vision HHS Secretary (Mike) Leavitt laid out originally” from 2005 to 2009 in the cabinet of President George W. Bush.

Alexander concluded the hearing by telling Azar that if he’s confirmed by the Senate “you’ll have a chance to implement” the 21st Century Cures Act—signed into law in December 2016—which includes several provisions designed to reduce the EHR burdens on providers and as well as to advance health IT interoperability. “There’s a lot here that we can do working with you.”

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