mHealth could see the benefits of recent announcements that push the needle on meaningful use and interoperability.
The Office of the National Coordinator of Health IT has completed its interoperability roadmap, setting out three-, six- and 10-year goals for the flow of data between consumers and providers and between different segments of the nation's healthcare system. Almost in unison, the Centers for Medicare and Medicaid Services issued the final rule implementing stage 3 of its meaningful use guidelines for the adoption of healthcare IT.
[See also: Interoperability lag drags mHealth down]
Both lean heavily on the participation of the consumer to enrich the medical record and, as a consequence, improve clinical outcomes – and that won't happen unless the consumer is allowed to participate through mobile devices at the time and place of their choosing. Providers, meanwhile, want that information to be relevant and reliable, placing the onus on the technology to deliver data in real time and in a format useful to clinicians.
"Exchange of information between health systems is flowing faster than ever before, and new technology innovations are bringing more usable digital health information to the bedside and beyond," Karen DeSalvo, the national coordinator, said in a preface to the roadmap. "We must build upon this success to create an open, person-centered health IT infrastructure – one that can support our neighbors not just as engaged patients, but as healthy citizens across their lifespan."
The goals set forth by the roadmap are as follows:
- "2015-2017: Send, receive, find and use priority data domains to improve healthcare quality and outcomes;
- 2018-2020: Expand data sources and users in the interoperable health IT ecosystem to improve health and lower costs; and
- 2021-2024: Achieve nationwide interoperability to enable a learning health system, with the person at the center of a system that can continuously improve care, public health, and science through real-time data access."
To achieve those goals, DeSalvo further outlines four "critical pathways" to long-term success. They are:
- "Improve technical standards and implementation guidance for priority data domains and associated elements. In the near-term, the roadmap focuses on using commonly available standards, while pushing for greater implementation consistency and innovation associated with new standards and technology approaches, such as the use of APIs;
- Rapidly shift and align federal, state and commercial payment policies from fee-for-service to value-based models to stimulate the demand for interoperability;
- Clarify and align federal and state privacy and security requirements that enable interoperability; and
- Coordinate among stakeholders to promote and align consistent policies and business practices that support interoperability and address those that impede interoperability."
Officials have said the roadmap focuses on action items, and compels providers to create a "learning health system" within the decade. But it also seeks to remove the roadblocks that have hindered providers and others in the industry, such as restrictive laws, weak reimbursements and confusing guidelines that hinder care coordination.
HIMSS is among the stakeholders praising the roadmap's direction, declaring its strong support for "the four critical pathways identified in the roadmap that focus on using consensus-based standards, enabling the shift in payment policies from fee-for-service to value-based models, and aligning federal and state privacy and security requirements that enable interoperability."
"We strongly believe that this roadmap will provide important guidance that will help improve consumer access to health data and the sharing of electronic health information among providers," Blair Childs, the Premier healthcare alliance's senior vice president of public affairs, said in a release. "We also support the roadmap's recommendations for broader, governmental action to promote consistent, national interoperability standards, including the use of open source application programming interfaces to support the secure transfer of information between and among different HIT platforms."
With stage 3 of meaningful use, mHealth advocates are cheered by the focus on data generated by the patient and added to the record.
Robert Jarrin, Qualcomm's senior director for government affairs and a longtime mHealth advocate, told Politico that the inclusion of patient-generated health data is an important step in connecting the consumer to the healthcare system.
"(It's) a victory for patients and families everywhere," he told Politico. "Being able to upload patient generated data into the electronic healthcare record seems obvious, but it's finally here."
Others weren't so positive, noting that providers are already burdened by federal initiatives that are sapping them of time, money and resources.
"Despite the urging of hospitals, physicians and Congress, the Stage 3 final rule includes many new and more challenging requirements. More than 60 percent of hospitals and about 90 percent of physicians have yet to attest to Stage 2," American Hospital Association CEO Rick Pollack told Healthcare IT News, a sister site to mHealth News and part of the HIMSS Media Group. "The Stage 3 rule is too much too soon."
If nothing else, the long-awaited government action might serve as a kick in the backside to healthcare leaders reluctant to embrace the mHealth movement, compelling them to at least start implementing basic patient engagement tools. It also adds a little bit of urgency to the mHealth movement, giving vendors and advocates more concrete guidelines and deadlines to prove their capabilities or step aside.
[See also: Making device data more meaningful]