At HIMSS, I listened carefully to payers, providers, patients, developers, and researchers. Below is a distillation of what I heard from thousands of stakeholders. It is not partisan and does not criticize the work of any person in industry, government or academia. It reflects the lessons learned from the past 20 years of healthcare IT implementation and policymaking. Knowing where we are now and where we want to be, here are 10 guiding principles.
Meaningful Use (MU)
See the following -
Halamka on The ONC 2015 Certification Rule
By John D. Halamka, MD | October 28, 2015
Just as I summarized the CMS Meaningful Use Final Rule last week, this week I’ll summarize the 560 pages of the ONC 2015 Certification Final Rule. Key points to understanding the rule include...The 2015 Certification Rule is decoupled from Meaningful Use. Thus, you’ll find functionality to support EHR Incentive Programs plus several certification criteria for long-term/post-acute care, chronic care management, behavioral health, and other programs such as merit-based incentive payments (MIPS).
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Halamka's 2016 Predictions for Health IT
By John D. Halamka, MD | December 26, 2015
As the year ends and we archive the accomplishments and challenges of 2015, it’s time to think about the year ahead. Will innovative products and services be social, mobile, analytics, and cloud (SMAC)? Will wearables take off? Will clinicians be replaced by Watson? Here are my predictions...Apps will layer on top of transactional systems empowered by FHIR...a better approach is crowdsourcing among clinicians that will result in value-added apps that connect to underlying EHRs via the protocols suggested in the Argonaut Project (FHIR/OAuth/REST). One of our clinicians has already authored a vendor neutral DICOM viewer for images, a patient controlled telehealth app for connecting home devices, and a secure clinical photography upload that bypasses the iPhone camera roll. That’s the future.
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Halamka's Advice to the Trump Administration
By John D. Halamka, MD | January 11, 2017
As I've listened to the confirmation hearings for cabinet nominees, I’ve realized that no one with healthcare IT expertise has yet been identified by the transition team. I continue to ask all my colleagues about any contact they’ve had with anyone advising the new administration - so far, no one has been asked anything by anyone related to healthcare IT. At this early time in the administration, it’s important to offer advice as to the priorities ahead for the next few years. What would I recommend to the new administration?
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Halamka's Next Steps for the National Healthcare IT agenda
By John D. Halamka, MD | March 1, 2017
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Halamka's Report on the August 2015 HIT Standards Committee
By John D. Halamka, MD | August 31, 2015
The August 2015 HIT Standards Committee marked the beginning of an important transition. As work on Meaningful Use winds down, it is being replaced with work on Obama’s signature precision medicine initiative and planning for the 2016 Interoperability Standards Advisory. At the same time, many of the longstanding HIT Standards Committee members of have reached their term limits and are being replaced by new experts. I will leave the group in January.
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Halamka's Report on the Joint HIT Standards and Policy Committee Meeting
By John D. Halamka, MD | October 11, 2015
All the members of the ONC Federal Advisory Committees met in Washington to review delivery system reform and the Interoperability Roadmap. We began the meeting with a thank you to Jodi Daniel, who will be leaving ONC after 10 years of service. Elizabeth Holland presented a data update on the Meaningful Use program. She noted that 2015 attestation will open Jan 4, 2016-Feb 29, 2016. The Meaningful Use Stage 2 final rule has not yet been released (but rumor suggests it may be released later today). Next, Karen DeSalvo presented a Delivery System Reform Update setting the context for the kinds of interoperability needed in the future as fee for service is replaced by population-based payment.
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Halamka: 2015 In Review
By John D. Halamka, MD | December 8, 2015
It’s now December and as each year ends, I always look back on the challenges and achievements of the past 12 months. Here’s my sense of 2015. ICD10 - billions were spent, countless other projects were delayed, and the transition occurred on October 1 without a major incident...Did we get our money’s worth? I have argued and will continue to assert that ICD-10 benefited no one. The diagnoses used are more variable so there is less precision in their use. Clinical documentation (in general in the industry) does not have the specificity needed to justify the more granular ICD-10 codes. The notion that quality measures can now be computed more accurately from ICD-10 coded administrative data is just not true...
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Halamka: Advice to the New National Coordinator
By John D. Halamka, MD | January 27, 2014
Karen DeSalvo started as the new National Coordinator for Healthcare Information Technology on January 13, 2014. After my brief discussion with her last week, I can already tell she's a good listener, aware of the issues, and is passionate about using healthcare IT as a tool to improve population health...What advice would I give her, given the current state of healthcare IT stakeholders?
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Halamka: Next ONC Chief Faces Small Budgets, Big Challenges
Jennifer Bresnick | EHR Intelligence | October 9, 2013
The next National Coordinator for Health IT has some big shoes to fill, says Beth Israel Deaconess CIO John Halamka, and will face an era of shrinking IT budgets, converging deadlines, and hard choices. [...] Read More »
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Halamka: Stage 2 Meaningful Use, ICD-10 Timelines Unrealistic
Jennifer Bresnick | EHR Intelligence | November 20, 2013
The current slew of health IT initiatives slated to hit the healthcare industry over the next year or so place unrealistic expectations on beleaguered providers [...]. Between Stage 2 of meaningful use, ICD-10 implementation, the HIPAA Omnibus rule, and the Affordable Care Act, providers simply have too much to handle in too short a timeframe to make everything work the way rule makers hope it will. [...] Read More »
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Halamka: What is the Optimal Future Role for ONC?
By John D. Halamka, MD | March 2, 2015
As Meaningful Use winds down and incentive dollars are fully spent, what is the optimal role for ONC going forward? Some pundits have suggested that ONC step aside and return all aspects of HIT policy and technology to the private sector. Others have suggested top down command and control of HIT including centralized governance to ensure interoperability. Harmony is when all parties feel equally good about the path forward. Compromise is when everyone leaves the table equally unhappy. Here’s my view about the future of ONC that includes points from both sides.
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Halamka: What Keeps Me Up At Night - Fall 2013
John Halamka | Life As A Healthcare CIO | September 3, 2013
All of these challenges can be conquered. For nearly 20 years, I've led an IT organization that has continuously delivered miracles with 1.9% of the operating budget. I am ready for the challenges ahead but wonder if mergers/acquisitions, regulatory uncertainty, MU2 certification challenges, resource constraints, and real time demands will create a set of constraints that are impossible to optimize.
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Half Of Healthcare Organizations Charge Patients For Copies Of Records
Akanksha Jayanthi | Becker's Hospital Review | January 7, 2015
Patient engagement in healthcare is increasingly becoming a priority for organizations, but for patients whose providers don't offer patient portals, most still have to request copies of their paper and electronic medical records...
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Has EHR Usability Suffered For The Sake Of Adoption Speed?
Jennifer Bresnick | EHR Intelligence | September 13, 2013
The need for speed may have left truly meaningful use of electronic health records in the dust, says Larry Pawola, Professor at the University of Illinois at Chicago Health Informatics in a blog for The Information Daily. Read More »
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Has Meaningful Use Lost Its Utility For Physicians?
Marla Durben Hirsch | FierceEMR | March 20, 2014
Now seems to be the time for physicians to evaluate their participation in the Meaningful Use program. After all, we're on the brink of leaving the carrot-only incentive phase and entering the penalty phase for those providers who don't meet federal requirements.
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