New Paper from American Medical Informatics Association Details How to ‘Cross the Health IT Chasm’

Wednesday, April 5, 2017

Health informatics experts discuss policy recommendations to improve health IT for patients, clinicians and researchers during briefing in Washington, D.C.

(WASHINGTON, DC) — The American Medical Informatics Association (AMIA) held a briefing today on Capitol Hill to unveil the findings and recommendations from a new paper, detailing ways that policymakers should focus on liberating data for patients, improving interoperability for clinicians, and enhancing the capacity for research and innovation to impact patient care. The paper, “Crossing the Health IT Chasm: Considerations and Policy Recommendations to Overcome Current Challenges and Enable Value-based Care,” is published in the Journal of the American Medical Informatics Association (JAMIA) in tandem with the briefing.

Over the last five years, the U.S. healthcare system has made a digital transformation faster than any other industry in modern times. However, today’s health IT infrastructure remains largely a collection of systems unable to deliver on promised benefits. “Crossing the Health IT Chasm” looks at our current healthcare landscape through the lenses of a patient, a provider and the research and innovation community, and includes 17 policy recommendations to help health IT better support a value-based system of health, care and research.

Paper authors crafted a vignette to illustrate the demands on health IT from multiple points of view, focusing recommendations to address key gaps between the idealized and current experience for these three perspectives.

The vignette envisions a not-too-distant future where patients access and transmit historic medical records from previous providers to new ones, or where providers can prescribe the use of mobile health applications to help patients control their conditions. The vignette also demonstrates how health IT makes clinical documentation simpler and identifying potential patients for a clinical trial easier.

These scenarios are possible using today’s health IT, but they are far from commonplace.  Specific policies are needed to:

  • Enable patients to have better access to their data in a computable format;
  • Improve interoperability in a context of Application Programming Interfaces (APIs);
  • Simplify clinical documentation for reimbursement and quality measurement;
  • More readily engage patients in research; and
  • Foster an ecosystem of safe, effective and secure health applications.

“These recommendations are meant to help decision-makers understand that the idealized vision for our digitized healthcare system is within grasp,” said lead author Julia Adler-Milstein, PhD, Associate Professor at the University of Michigan’s School of Information. “Coordination – above all else – is how we take the health IT tools of today and achieve the promise of better patient care of tomorrow.”

Speaking at briefing on Capitol Hill in Washington, D.C., AMIA President and CEO Douglas B. Fridsma, MD, PhD, FACP, FACMI, said, “We have made great progress in adopting EHRs in the last six years, but now our charge is even more difficult.  Now we must develop and implement strategies that allow all stakeholders – patients, clinicians, researchers, developers and policymakers – to truly benefit from a connected, innovative health ecosystem. Policy recommendations developed in this paper have given decision-makers a host of options necessary to accomplish this.”

Developed to support “Crossing the Health IT Chasm,” AMIA issued a set of “Policy Action Items,” identifying several immediate, near-term and future actions policymakers could take to (1) Improve patients’ access and use of their data; (2) Improve interoperability and clinical utility of patient data; and (3) Enhance the capacity for research and innovation to impact patient care.  Specific immediate action items include:

  • Clarifying a patient’s HIPAA “right to access” to include a right to all data maintained by a covered entity’s designated record set;
  • Encourage continued adoption of 2015 Edition Certified Health IT so that standards-based APIs, published in the public domain, become a standard feature and can continue to be deployed by providers; and
  • Make effective Common Rule revisions as finalized in the January 19, 2017 issue of the Federal Register.

About the paper and authors
Crossing the Health IT Chasm” was based, in part, on the findings and recommendations of AMIA’s EHR 2020 Task Force Report, and in part on the outputs of AMIA’s 2015 Policy Invitational.

The paper was co-authored by Julia Adler-Milstein, PhD, Associate Professor at the University of Michigan’s School of Information; Peter J. Embi, MD, MS, President and CEO Regenstrief Institute, Inc.; Blackford Middleton, MD, MPH, MS, Chief Informatics and Innovation Officer with Apervita; and Neil Sarkar, PhD, MLIS, Founding Director, Brown Center for Biomedical Informatics. Bios available here.

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AMIA, the leading professional association for informatics professionals, is the center of action for 5,000 informatics professionals from more than 65 countries. As the voice of the nation’s top biomedical and health informatics professionals, AMIA and its members play a leading role in assessing the effect of health innovations on health policy, and advancing the field of informatics. AMIA actively supports five domains in informatics: translational bioinformatics, clinical research informatics, clinical informatics, consumer health informatics, and public health informatics.

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