HIT Think

Why Washington wants more input on health IT initiatives

Health IT executives: Washington needs your help.

That message rang loud and clear from both sides of the aisle and across federal agencies at the second annual CHIME Advocacy Summit on June 26 to 28 in Washington. Whether it is providing supporting data, sharing anecdotes, responding to requests for information or taking the ultimate step of becoming a politician, CIOs and other health IT leaders can help shape policies affecting telehealth, cybersecurity, interoperability and the opioid epidemic.

“We are still lacking cost-effectiveness data,” said Rep. Doris Matsui (D-Calif.), author of the bipartisan Excellence in Mental Health Act and sponsor or co-sponsor of numerous bills promoting telehealth, cybersecurity and the use of 5G. Although there has been some progress recently, reimbursement for telehealth visits has been stymied without data that shows telehealth lowers costs and improves quality – or at least is on par with in-person care. “I need your support going forward,” she said.

Rep. Greg Gianforte (R-Mont.), echoed Matsui’s request. A strong proponent of telehealth to serve his largely rural constituency, he pointed to the Congressional Budget Office (CBO) as a hurdle that health IT leaders could help overcome. CBO has voiced concerns that more accessibility to healthcare through telehealth will increase use and therefore costs. That calculation doesn’t account for savings from alternative choices such as costly emergency room visits. “We need to educate CBO so they can score properly,” he said.

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President Barack Obama delivers a health care address to a joint session of Congress at the United States Capitol in Washington, D.C., Sept. 9, 2009. (Official White House Photo by Lawrence Jackson) This official White House photograph is being made available only for publication by news organizations and/or for personal use printing by the subject(s) of the photograph. The photograph may not be manipulated in any way and may not be used in commercial or political materials, advertisements, emails, products, promotions that in any way suggests approval or endorsement of the President, the First Family, or the White House.

Rep. Bill Foster (D-Ill.) received a round of applause for co-sponsoring an amendment to eliminate a ban on a unique national patient identifier. The House approved the amendment in June, and now the Senate must follow suit for the issue to go forward. The 20-year prohibition is seen as a barrier to interoperability and a risk to patient safety.

Foster offered an example that illustrated that risk: a passenger who experienced cardiac arrest on a flight that then was diverted to land and get emergency care. The provider misidentified the passenger as DNR—a person who had a Do Not Resuscitate order—and the passenger subsequently died. Foster encouraged the audience to provide other examples that highlight the consequences of not having a unique patient identifier. “This is a painful subject for you, but go into medical errors,” he said.

U.S. Rep. Bill Johnson, (R-Ohio), and the sponsor of several telehealth bills, offered the prospective of a former CIO. A retired lieutenant colonel in the U.S. Air Force, he served as director of the Air Force’s Chief Information Officer Staff at U.S. Special Operations Command, followed by four years as a CIO for a global manufacturing company.

Johnson cited the many benefits of telehealth, including telestroke services, virtual surgical support and remote care for people dealing with opioid addiction. He recommended health IT leaders “talk in a way people can understand” when advocating for change and added that the audience members should consider running for office to make an even greater impact on policy.

Policymakers from numerous federal agencies also offered advice for shaping policies. Michelle Schreiber, MD, director of the Quality Measurement and Value-Based Incentives Group at the Centers for Medicare and Medicaid Services, urged the audience to read proposed rules, respond to RFIs and provide practical, real-world recommendations for operationalizing the proposed rules. “Read the RFIs and look at the questions,” she advised. “The questions are signals.” CMS reviews the comments and can be influenced by compelling responses, she said.

Admiral Brett P. Giroir, MD, assistant secretary for health at the Department of Health and Human Services, called on the audience to use their expertise and insights to help address the opioid epidemic. As senior adviser to the Secretary for Opioid Policy, he is responsible for coordinating HHS’s efforts across the administration to fight America’s opioid crisis. Existing technologies like EMRs, dashboards, clinical decision support tools and data analytics already are proving useful for monitoring prescribing and reducing patients’ exposure to opioids, he noted.

With improvements in interoperability, health IT-based tools may help to track children who have been exposed to opioids in the womb to provide long-term care and support, Giroir suggested. In the meantime, he urged the audience to share stories of what worked and what didn’t with HHS.

The second annual CHIME Advocacy Summit, which was held in Washington, included presenters from Congress, CMS, the Office of the National Coordinator for Health IT, the National Institute of Standards and Technology, Federal Trade Commission, the Office for Civil Rights and other agencies. Presenters included members of CHIME’s Policy Steering Committee and the CHIME Opioid Task Force. The event concluded with visits to Capitol Hill, where participating CHIME members met with their congressional staff to advocate on behalf of CHIME and for CHIME’s policy priorities.

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