Experts Weigh In on Health IT Progress, Disappointment in 2014 & Hopes for 2015

Health IT interest, adoption and use saw big strides in 2014. But debate surrounding federal health IT initiatives, regulation and the future of the Office of the National Coordinator for Health IT also grew over the last year.

For the fourth year in a row, iHealthBeat asked a variety of stakeholders to weigh in on health IT progress, disappointments and hopes for the future.

Each health IT expert answered three questions about the most significant health IT development in 2014, the biggest disappointment in the past year and how the remaining barriers to widespread health IT adoption should be addressed in 2015.

Before finding out what the experts think, here's a quick look back at 2014.

Meaningful use

Incentive payments to eligible hospitals and professionals participating in the meaningful use program reached $25.7 billion in 2014.

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.

According to ONC, more than 93% of eligible hospitals and 76% of eligible professionals now meaningfully use health IT.

However, at the end of the year, CMS announced that more than 257,000 eligible professionals will be penalized in 2015 for failing to meet Medicare meaningful use requirements.

Joining a chorus of many health care provider organizations, a group of 30 members of Congress in December 2014 sent a letter urging HHS Secretary Sylvia Mathews Burwell to provide eligible professionals and hospitals with more flexibility to meet reporting requirements for the meaningful use program. Led by Rep. Renee Ellmers (R-N.C.), the lawmakers called on Burwell to shorten the 2015 reporting period to 90 days to "give providers much-needed time to safely and effectively implement certified technology and continue their 'meaningful use' journey."

They added, "Our constituents remain concerned that the pace and scope of change have outstripped the capacity of our nation's hospitals and doctors to comply with program requirements." Ellmers also has introduced a bill (HR 5481) to require a three-month reporting period in 2015 for Stage 1 and Stage 2 rather than a full-year reporting period.

ICD-10

Stakeholders have been engaged in a year-long debate over whether the latest deadline for new billing codes will -- and should -- stick.

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures.

In August 2012, HHS released a final rule that officially delayed the ICD-10 compliance date from Oct. 1, 2013, to Oct. 1, 2014.

At the Healthcare Information and Management Systems Society's annual conference in February 2014, CMS Administrator Marilyn Tavenner said that there would be no additional delays to ICD-10.

But in April 2014, President Obama signed legislation (HR 4302) that pushed back the ICD-10 compliance date again -- until at least October 2015.

CMS then established Oct. 1, 2015, as the new ICD-10 compliance deadline for payers and providers still making the transition.

Some groups -- including the Medical Society of the State of New York, the Texas Medical Association and the National Physicians' Council for Healthcare Policy -- said the additional one-year reprieve still wasn't enough, and they continued to push lawmakers and federal officials for more time.

On the other side of the debate, organizations, such as the American Health Information Management Association, have been adamant that additional delays will only hurt the health care industry, noting that "each delay has cost the industry billions of dollars, as well as the untold costs of lost benefits from implementing a more effective code set."

Health IT regulatory framework

Meanwhile, the federal government's risk-based health IT regulatory framework prompted mixed feedback from health care stakeholders.

The American Medical Association in a letter to FDA warned that the draft health IT framework fails to provide a viable approach to addressing patient safety risks without stifling innovation, while HIMSS said that it "supports the general approach described in the draft report," but urged FDA to add an additional health IT category to its framework to include health IT functions related to diagnostics, pharmacy and procedural health.

Congress is poised to take up health IT regulation this year.

Rep. Marsha Blackburn (R-Tenn.) said that an updated version of the Sensible Oversight for Technology which Advances Regulatory Efficiency (SOFTWARE) Act of 2013 (HR 3303) would be part of the 21st Century Cures package that the House Energy and Commerce Committee is set to consider this month.

Meanwhile, Sens. Michael Bennet (D-Colo.) and Orrin Hatch (R-Utah) in December 2014 introduced the Medical Electronic Data Technology Enhancement for Consumers' Health  -- or MEDTECH -- Act (SB 2977), which would provide more clarity regarding regulatory expectations and limit FDA's oversight of low-risk medical software and mobile applications.

ONC action

ONC released three important reports this year -- a 10-year roadmap for achieving an interoperable health IT infrastructure, a 10-year vision report for leveraging health IT to enable quality improvement in health care and the new Federal Health IT Strategic Plan for 2015 to 2020. Meanwhile, ONC itself saw some big changes in 2014.

National Coordinator for Health IT Karen DeSalvo in October 2014 announced that she would serve as acting HHS assistant secretary for health, effective immediately, where she will lead HHS' Ebola response team.

Lisa Lewis, ONC's COO, became acting National Coordinator for Health IT, while DeSalvo continued to support ONC's work in her new role.

Other high-profile departures at ONC include former Deputy National Coordinator for Health IT Jacob Reider; Judy Murphy, who served as chief nursing officer and director of ONC's Office of Clinical Quality and Safety; Doug Fridsma, former chief scientist at ONC; Joy Pritts, former chief privacy officer at ONC; and Lygeia Ricciardi, who stepped down as director of ONC's Office of Consumer eHealth.

While some health care stakeholders said the transitions at ONC could jeopardize the future of federal health IT programs, others welcomed the changes as a new opportunity for the private sector take the lead.

With private-sector heavyweights like Apple, Google and Samsung entering the health IT market, it seems the country might be ready for just that.

Now, here's what some of the country's top health IT experts think about the past year and their hopes for 2015.

Source: iHealthBeat, Monday, January 5, 2015

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