AHIC Closes Shop after Three Years with High Hopes for Health IT
The American Health Information Community concluded its work with praise for what it accomplished and a warning that its work could be undone if its members don’t speak up. AHIC is transferring most of its work to the public-private AHIC Successor as a new administration looms. Health and Human Services Secretary Mike Leavitt said there will be a national conversation about health IT, and those who don’t understand the progress AHIC has made may try to start the work over. “I'm deeply worried about that,” he said.
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Everyone seems to be in favor of electronic health records, but they're hard to adopt, Leavitt said. “In the last five years, I think electronic health records have gone from something that a few talked about to almost platitudinal acceptance,” he said. Leavitt compared AHIC’s progress to the foundation poured at a construction site, largely ignored by passersby. Once that work is done, framers can begin putting up the building, and that’s when people really take notice, he said. If Congress builds on what AHIC has done, rather than replacing it or starting over, the country will see health IT adopted speedily, he said.
AHIC gave Leavitt the last of its recommendations. The EHR workgroup recommended that HHS commission an expert panel to study differing reporting requirements of outside groups like the Centers for Medicare and Medicaid Services, the Joint Commission, the Healthcare Facilities Accreditation Program, private insurers and others. Those differences slow adoption of health IT, the workgroup said. The workgroup also suggested that HHS set up a clearinghouse for EHR templates and create a standardized methodology for measuring direct and indirect costs of EHR adoption.
AHIC uncovered issues that illustrate the “new frontier of federalism,” as governments struggle to understand what constitute proper state and federal roles in an age when information exchange makes political boundaries less relevant, Leavitt said. “We have to define again what, quote, sovereignty means,” he said. Noting that he has defended states’ rights throughout his career, Leavitt said states need to understand they must stay ahead of technology and collaborate. If states try to maintain control of things like forms, the federal government ultimately will step in and take that power, he said. Instead, states must concentrate on working collaboratively in these ventures so they protect their most important authority, decision-making, he said.
PHR Pilot Program Announced
Leavitt and acting CMS Administrator Kerry Weems announced a pilot personal health record (PHR) program in Arizona and Utah. Starting in January, Medicare recipients can choose from four PHR providers. Normally, because patients rather than doctors or hospitals own PHRs, the patient must input all the data, but in this project, to get patients started, Medicare will fill in two years’ worth of claims histories. The one-year program will help the government and vendors learn what works and help seniors take more control of their health, Weems said. CMS will evaluate the program based on user satisfaction, perceived benefits and concerns, functionality and how the records affected care.
Google Health, HealthTrio, NoMoreClipboard.com and PassportMD will offer the PHRs. CMS contractor Noridian Administrative Services helped choose the four from 40 vendors that expressed interest. Along with the two-year Medicare claims histories, PHRs will incorporate continuing updates and links to other information, such as pharmacy data, wellness and health education and drug interaction education.
The pilot PHRs are free to patients, as is the case with all such records, but CMS has to cover $2.5 million in administrative costs. The key difference is the two years’ worth of information that Medicare provides. During the AHIC meeting, Leavitt cited online banking’s earliest days. Early adopters -- geeks -- are willing to type in information themselves because it’s great to have the data, he said. In time, others start using the product when it gets easier to use. “We have surpassed the geek factor in this pilot,” Leavitt said.