I must have some free time today because I am reading the Federal Health IT Strategic Plan for 2015-2020. It describes a set of overarching goals that align with HHS’ aims of improving health care quality, lowering healthcare costs, and improving the U.S. population’s health. The goals are simple.

1. Goal 1 – Expand and adoption of Health IT

2. Goal 2 – Advance secure and inter-operable health information

3. Goal 3 – Strengthen healthcare delivery

4. Goal 4 – Advance the health and well-being of individuals and communities

5. Goal 5 – Advance research

I love it…conceptually. I truly hope this works. The problem I see is the reality. Can we meet these goals? We can map it out all we want, but the real challenge is getting there. The document for the Federal Health IT Strategic Plan is mostly an explanation of how we are going to get there. If I read further, I see the WAY we are going to get there. Very simple…incentives and penalties. The will leverage the Federal Government since it is the nation’s largest payer. HHS will pursue a natural lifecycle of policies to drive interoperability beginning with incentives, followed by payment adjustments and then conditions of participation in Medicare and Medicaid programs. HHS is now pursuing ways to promote interoperability as a core element of delivery system reform for providers across the country. An important recent policy demonstrating this commitment is the separately billable payment for chronic care management, finalized under the 2015 Physician Fee Schedule. In order to bill for these services, physicians will be required to utilize certified health IT to furnish certain services to beneficiaries.

Further down in the Federal Health IT Strategic Plan, they mention leveraging purchasers of healthcare, including large employers. It is mentioned they can contribute directly to interoperability by selecting a contract with a plan that commits to the use of interoperability, and they are suggesting purchasers can commit to sponsoring benefit plans that encourage employees to choose providers that are using interoperable health IT. I don’t disagree with this. I have always felt the patient should have a large say in the sharing of ePHI.

Over the past several years, I will admit, we have made progress. We have a higher number of Physicians using an electronic medical record. We have HIPAA in the forefront, helping practices secure the information, and we have incentives by was of cash to share data. The groundwork has been laid. Now we have to get over the hump.

According to the Federal Health IT Strategic Plan, the way we are going to get over this hump is to create additional incentives, and reward hospitals and practices for sharing information. HHS is continuing to test and advance new models of care that reward providers for outcomes. It will help to create an environment where interoperability makes business sense. I like it, but at what cost?

If you ask me…which you didn’t, I think the Federal Government is going to have a hard time controlling something they don’t own. They do not own the Electronic Medical Records that are used in physician practices. They do not own the software used in Hospitals. Because of this, they cannot control it. You cannot control the Doctors business. The hospital is a business. There are too many variables against making this work. Believe me, I really hope it does. I am a proponent of exchanging health information. I really want to see it. Just not sure I will.


Below is an image from the Healthcare IT News website.