Healthcare Reform

2021 Acceleration: Meeting the Demand

Medical professionals in a surgery

In 2021, the world is facing a critical demand for the acceleration of health, which can only be addressed by first establishing a proper diagnosis. Members of the HIMSS leadership team have identified some of the common problem areas we share as a global society and a health citizenship, and they have provided recommendations on how best to meet this need for acceleration. Ultimately, the accelerated delivery of solutions in healthcare is vital to realizing the full health potential of every human, everywhere.

Information technology has always been at the center of innovation. It has created a path for the best data to be delivered at the right time to guide accurate and informed decision-making, an approach that is leveraged across industries. However, in healthcare – due in part to a complex array of stakeholders, a web of IT systems, concerns around data privacy and safeguards to protect patient health and safety – innovation has often lagged. That is, until now.

Read more on 2021 Acceleration:


Tom Leary


 

"Health IT leveraged in the right places makes a world of difference."
– Tom Leary, Senior Vice President, Government Relations, HIMSS


 


2021 will be the year to leverage health information and technology to ensure equitable distribution and tracking of the COVID-19 vaccine and personal protective equipment.

Value over volume

The U.S. has been on a five-year march toward value-based care, and the rest of the world is waking up to the idea that you have to focus on value, not volume.

Governments do not have a blank check to cover the rising costs of healthcare delivery, but people across the world are in need of assistance and care. There must be a way to find more efficiencies. Value over volume will take center stage. Regardless of how healthcare is delivered or financed, governments are looking to improve on the value of care. We expect more of them to utilize information from IT systems to help make informed decisions about care delivery.

Solving for the pandemic and tracking the vaccine

Tracking and tracing is not simple. It becomes a privacy issue. According to public health officials, people are not convinced their privacy will be protected throughout the tracking process, so many choose not to participate. The technology may be available, but who feels comfortable using it? This issue is limiting the data we have to influence important policy changes.

So how do we make tracing useful? Different countries and jurisdictions take different approaches. The perception of privacy invasion tends to ebb and flow.

The European Union is looking at how to adjust GDPR and apply the many lessons learned. The U.S. is trying to collect best practices from GDPR, but not duplicate it, since we have different cultural expectations. One solution won’t work for the entire world. We have the technology, but there must be a partnership between the individual and the government.

Another area of privacy concern is cybersecurity, which is getting more difficult. Healthcare is going to continue to be the No. 1 sector being targeted and attacked by cybercriminals.

At the same time, we need more interoperability throughout the healthcare industry. There may not be as many resources for investment, but people will invent creative solutions to the various problems we’ve uncovered in 2020.

That’s the positive side. There will be new solutions that will decrease the headache around information sharing in public health and mainstream healthcare.

The role of data

2021 will also be a big year to finally identify common data elements that can be used by policymakers  to take action to change policy to reduce burden for patients and providers.

With the incoming Biden administration in 2021, we may see more presidential advocacy for health information and technology, with a particular emphasis on innovation that can improve access for all communities. President Obama and then-Vice President Joe Biden rewrote the book on innovation six years ago by creating the U.S. digital service and bringing in people from different industries. We will be closely watching how President Biden and his team approach access, patient privacy and patient responsibility. We’re at a place with the partnership between the patient and the provider with a clear role for the caregiver. We’re not going to be talking theory anymore. It’ll be a big change for 2021.

Accessing patient data

The issues of patient matching and patient identity integrity goes back to the beginnings of HIPAA, which called for the creation of a unique patient identifier. Since 1998, Congress has stated that the Department of Health and Human Services could not pursue a plan  unique identifier without prior approval from Congress.

We believe this is a serious misinterpretation of Section 510 of Labor-HHS Appropriations Bill, but it lasted for more than two decades. The coronavirus crisis has made clear just how critical proper patient identification impacts care delivery.

Working alongside our Patient ID Now founders, the American College of Surgeons; American Health Information Management Association; College of Health Information Management Executives; Intermountain Healthcare; and Premier, we at HIMSS are encouraging the U.S. Congress to lift the ban on HHS active involvement in the development of a National Patient Identification Strategy.

Accurate identification of patients is one of the most difficult challenges in a public health emergency. Nationally, 80 percent of coronavirus tests are missing key demographic information; 50 percent do not have an address. Without the ability to accurately identify and match patients to their health information, critical information is lost, and safe, effective and timely diagnosis is difficult, if not impossible. Public health decision making is undermined.

Lack of a national patient identification strategy exacerbates health disparities in underserved communities. According to OCHIN, in a nonprofit health IT service provider with more than 500 care delivery sites:

  • Black patients make up 13 percent of the patient population but 21 percent of duplicates
  • Hispanic/Latino patients are 21 percent of the patient population, but 35 percent of duplicates
  • The homeless population makes 4 percent of patients, but 12 percent of its duplicates

A national patient identification strategy is critical in preparing for timely distribution of a COVID-19 vaccine, which requires accurate patient information about who has had the disease, who has been vaccinated and data on patient outcomes and supply chain requirements. This is particularly crucial as many of the vaccine  requires multiple doses.

Ensuring that the correct patient medical history is accurately matched to the patient is also critical for future patient care, for claims billing, for patients’ long-term access to their complete health record and for tracking the long-term health effects of COVID-19.

Privacy issues and the current health crisis

There have long been concerns about the creation of a centralized repository with detailed information about individuals and the potential that it could be used for discriminatory purposes, particularly as it relates to vulnerable populations. There are also questions about HIPAA requirements for privacy and the need for patient control and consent.

While these concerns are important, the current system has created its own privacy challenge: patients must disclose individually identifiable information to each healthcare provider they visit, which creates opportunities for inadvertent disclosure of a patient’s health information in ways that violate privacy.

It is absolutely clear that we must find the right balance between patient privacy and safety. The cost to health in this country of not doing so is too high.

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