If anyone has a global perspective of the changes occurring within federal policy on healthcare IT, it’s probably Paul Tang, MD.

Tang, as vice president and CMIO for the Palo Alto Medical Foundation, has made it a mission to stay deeply involved with healthcare IT initiatives that federal agencies have created to get private input on healthcare IT.

Paul Tang, MD
Paul Tang, MD

In addition to Tang’s day job with the Palo Alto Medical Foundation, he carries a heavy load on various federal panels, including chair of the Advanced Health Models and Meaningful Use committee, vice chair of the Health IT Policy Committee, member of the Health IT Strategy and Innovation committee and chair of the Clinical, Technical, Organizational and Financial Barriers to Interoperability task force.

HDM Editor Fred Bazzoli caught up with Tang recently to get his take on the direction of current developments at the federal level, and how it could affect health IT.

A few weeks have passed since the statements from policy makers on the future of meaningful use. In your opinion, what is the best possible direction for the program?
The purpose of meaningful use was to put in place an electronic infrastructure for health data—something that didn't exist just five years ago. I think the meaningful use program has done a tremendous job of accomplishing that objective.

Now, it is up to payment reform to "pull" the data across organizational boundaries (using interoperability) to facilitate care coordination and better management of outcomes. That's not a technical problem. It's more of a socio-cultural political issue, which is why it will take payment reform to properly motivate all the stakeholders. The meaningful use program will be an enabler for delivery system reform.

The program has been successful in getting EHRs into hospitals. What do you feel is the most important next steps for providers that have implemented these systems?
From an implementation point of view, the next step is optimization. From a value point of view, the next step is to measure the outcomes of the care as drivers to continuous improvements.

Optimization is a wish for many organizations that want to get more value out of their EHRs. What are key steps for organizations that want to optimize their systems?
Often, EHRs are implemented in a bit of a hurry. So decisions had to be made fairly quickly. Optimization involves configuring the system to better support optimal (not necessarily the paper-based) workflows and also to teach clinician users to be more proficient in using the EHR tools.

Reimbursement incentives are changing to reflect value and quality. What new IT systems and capabilities will providers need as they make this transition from volume to value?
We need to examine the outcomes of what we currently do and find ways to do a better job, at higher value. Data analytics are important on both sides of this equation—to learn what interventions work and which do not, and, through prediction, to help clinicians make better decisions at the point of care.

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