Tuesday, May 26, 2009

Dr. Blumenthal Speaks at Brookings

HHS’s Office of the National Coordinator for Health Information Technology has come out of the shadows and is now in the spotlight, according to David Blumenthal, M.D., HHS National Coordinator. He explained that the funding for the health technology program went from $60 million to $2 billion and this means that the office is going to be implementing the agenda instead of just advising HHS.

Dr. Blumenthal discussed his thoughts at the May 20th Forum held at the Engelberg Center for Health Care Reform at Brookings Institution. He explained that since arriving at HHS, there have been efforts to define “meaningful use” since the ARRA legislation refers to the “meaningful use” of health IT. He said his idea of “meaningful use” would focus on outcomes rather than adoption.

Dr Blumenthal continued to say that the most important question to ask is how health IT relates to health reform. Health reform is essential in order for health IT to play an essential role in healthcare. The need is strong to make healthcare efficient and at the same time reduce the rate of growth for costs. HIT will play a critical role in health reform by managing the information so that the technology can assist healthcare providers to make important and life saving decisions.

According to Mark McClellan, M.D. PhD, Director for the Engelberg Center, also commenting on the subject “meaningful use”, noted that is very important for the term “meaningful use” to refer to the maximum impact on patient care. There is little reason to support health IT if the results don’t show an increase in the efficiency and quality of healthcare delivery. Also, performance measures need to be integral in order to validate “meaningful use”. It is essential to know whether or not payments for health IT use are actually facilitating improvements in health.

He also commented on the importance of how health IT payments fit into the broader reform environment. According to a recent Brookings White Paper, health IT bonus payments are only one of several new payment incentives to improve quality that will face providers in the coming years. It is also thought that Medicare will expand its-pay-for-reporting initiatives in the years ahead. Further payment reforms that may be applied on a broader scale in the coming years may include payments to medical homes, bundled payments, and accountability-based payments.

Medical homes are set up to effectively coordinate care for patients especially with chronic illnesses. These payments could be disbursed in addition for fee-for-services reimbursement. Also, the bundled payment system approach would pay providers a single fee to cover the entire duration of care for a patient’s particular health problem. Under the accountability-based payment model, physicians and hospitals participating in an Accountable Care Organizations would work toward cost savings benchmarks based on local historical cost trends and care improvement targets.

Several Forum panel discussions were moderated by Carol Diamond, Managing Director, the Markle Foundation, and John Tooker, CEO American College of Physicians. Panelists from the public and private sectors offered their ideas on the lessons learned from ongoing initiatives.

Panelist Neil Calman, President and CEO of the Institute for Family Health, discussed how the Institute’s community network covering 150 miles helps to provide the right data and how the information indicates general trends at the centers, determines if equality is being achieved in the outcomes achieved at the centers, and enables patients to communicate with their providers. The Institute is now able to link up and report to the public health system with the essential information going directly to the providers at the point-of-care.

Another panelist, John Toussaint, President and Founder, ThedaCare Center for Healthcare Value, and Chair, of the Wisconsin Health Information Organization, reported that the organization is reporting data to help provide the highest value at the lowest cost. Health IT can play an important role in retrieving the data so that providers and patients can make better decisions.