Catalyzing transformation of the health ecosystem
By Anil Jain | 3 minute read | November 18, 2019
Two long-awaited rules that promote interoperability have been the talk of the industry since they were first released in February of 2019. The 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program is the proposed rule from the Office of the National Coordinator for Health IT (ONC), and it implements certain provisions of the 21st Century Cures Act passed back in December 2016. The Interoperability and Patient Access Proposed Rule from the Centers for Medicare and Medicaid Services (CMS) advances data exchange and promotes patient access to electronic health information through standard terminologies and interfaces.
The final rules are expected before the end of the year, and they could go into effect as early as January 1, 2020. Both of these proposed rules are intended to increase innovation and competition by making information more accessible and usable among patients and their caregivers. In addition, they propose standards for representing electronic health information and ensuring that common technologies can be used to exchange that information among stakeholders, especially the patients.
IBM Watson Health has participated in conversations that help policymakers better understand the real-world impact of these standards and regulations. We engage in industry policy discussions because meaningful interoperability and precision regulation around the “what” and “why” is critical for us in our support of our clients, customers, and partners. To tackle the “how,” we approach three essential domains to help accelerate the transformation that we see in the health ecosystem:
1. Focus on the consumer.
Patients deserve to be informed, educated consumers of healthcare services. They are entitled to transparency in price, quality, and performance and make value-driven choices unique to them. Patients should have unimpeded and secure access to their own healthcare data, as well as the ability to share it as needed.
Empowering consumers with the ability to access to their own health information is fundamental to having engaged patients. In my opinion, the freedom for them to seek care when and where they choose and the ability to use digital health applications for their health and disease self-management can help lead to improved patient experience. Providers, health plans, government agencies and life science companies are using IBM Watson Health solutions to help them achieve their goals of providing an improved patient experience.
2. Value-based care delivery and reimbursement.
Meaningful Interoperability is the backbone of sustaining the industry’s ongoing transition from fee-for-service to value-based models of care. That is, reimbursing providers for the quality, cost and outcomes they achieve rather than how much and how often care is provided. But for true accountability, providers – including clinicians, insurers, case managers and others – should have access to information, insights, and tools that can help them work towards providing high-quality, accessible and affordable care.
Moreover, health information should be shared among the care team which may extend beyond the four walls of a single organization. It helps providers deliver optimal care when connected longitudinal data can help reduce errors and potentially improve patient safety, reduce unnecessary and redundant services, promote population health while individually tailoring care decisions and enable more coordinated care.
3. Research and innovation.
Interoperability standards and unimpeded health information exchange can help improve data quantity and quality used for clinical research. When aggregated (with appropriate privacy safeguards), these data sets in the hands of clinically focused data scientists using traditional analytics and machine learning can potentially lead to novel hypotheses that can benefit us all. For example, having a more complete longitudinal record when pooled can allow this data to help drive the detection of safety signals and outcomes for health services research. It is not surprising that the FDA, CDC, and NIH have all taken great interest in interoperability standards such as Fast Healthcare Interoperability Resources (FHIR) to accelerate research and innovation.
IBM advocates for policies that can enable patients to have secure access to their electronic health information during their care journey, whether clinical data in their EHR or administrative claims data in a database. We support precision regulations with realistic expectations and timeframes that can help move the nation closer to achieving actionable interoperability. We’ve also joined with other cloud providers to make a public commitment to interoperability.
Because our clients include providers, health plans, employers – and we collaborate with other health IT vendors as a systems integrator – we are invested in interoperability solutions that respect the patient and “work” for all stakeholders. Together, we will continue to advance interoperability to help our clients work towards their goal of improving healthcare for the populations they serve.