HHS drafts 5-year IT plan that maps out profound change for providers, payers

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Crystal Yednak Senior Manager, Health Research Institute, PwC US January 24, 2020

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draft five-year strategic plan for US health information technology would push the industry even more toward interoperability, putting the consumer in charge through an emphasis on making patient health information available through apps, disclosing price information and connecting the data held in different parts of the health ecosystem.

The draft plan released last week by the Office of the National Coordinator for Health Information Technology (ONC) aims for a healthcare landscape where patients can shop for care and where research and innovation are enabled by a robust exchange of data, all while patient data is protected as it moves through the system. It also encourages increased use of machine learning, smart dashboards, evidence-based clinical decision support, and telehealth to improve care and patient experience.

“Most healthcare providers and health systems now use electronic health records (EHRs), but information captured in these systems often remains inaccessible to patients, caregivers, and healthcare providers across different settings,” wrote Dr. Donald Rucker, the national coordinator for health information technology, in the opening letter of the report.

In the picture sketched out by the report, a more interoperable health system would empower health organizations to better act on social determinants of health and value-based care strategies, while empowering better decision-making from both clinicians and consumers.

The ONC five-year plan comes as the industry is awaiting final rules from CMS and ONC that would force a cultural and technological shift in the way the industry approaches data sharing. The proposed rules released in February 2019 would require certain payers in government plans to make patient health information available through application programming interfaces (APIs) and to share patient data with other payers as consumers change health plans. Entities would be prohibited from hoarding data within their own organization, and providers would have to provide electronic notification to other providers when patients are admitted, transferred or discharged.

ONC will communicate industrywide progress on the plan goals in its annual report to Congress. Public comments are being accepted until March 18.

HRI impact analysis

While continuing the drive toward interoperability, the plan also emphasizes product and price transparency, a source of concern for an industry that fears how forced sharing of prices could upend negotiations between providers and payers as well as employers and payers.

While the strategic plan outlines a road map for a future federal strategy, some of the ideas in the plan are already in the works through regulatory proposals from CMS and ONC. The proposed rules, if enacted as written, would significantly increase the onus on organizations to share their data and have provoked intense lobbying in DC.

Compliance could require significant investments, realignment of priorities and new workflow processes. Meanwhile, the increased sharing of patient data with third-party app developers raises important questions about how patient data is being used in an interoperable world.

Organizations should review their policies to protect their reputations and reduce their risks. HRI’s new report “Beyond IT: Why the Regulatory Push Toward Interoperability Requires Whole Organizational Responses From Providers, Payers” explores the implications for the industry as new entrants eye the opportunities that may be presented from this freer flow of data.

Read our research

Contact us

Trine K. Tsouderos

HRI Regulatory Center Leader, PwC US

Tel: +1 (312) 241 3824

Crystal Yednak

Senior Manager, Health Research Institute, PwC US

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