Marchibroda: A vote for financial incentives, standards adoption

The eHealth Initiative’s Sept. 29 testimony to the House Government Reform Committee was a progress report on the development of a national health information technology strategy and challenges to achieving interoperability among health IT systems.

The testimony was drawn from eHealth Initiative’s experience in local communities and from the initiative’s research, which produced “Parallel Pathways for Quality Healthcare,” a framework for aligning financial incentives with quality and HIT. Other research includes a recently released survey of 109 health information exchange initiatives located from almost every state and the District of Columbia.

The initiative’s testimony was an overview of:

* The state of IT and health information sharing.

* The progress and challenges related to developing a national health IT strategy.

* The exploration of efforts to develop standards for the collection and use of health information to facilitate information sharing.

* The challenges to achieving interoperability among health IT systems.

The audience was appropriate because the House Government Reform Committee has jurisdiction over the Federal Employees Health Benefits Plan (FEHBP), which insures 8 million federal employees and their dependents. The combined purchasing power of the FEHBP and the Centers for Medicare and Medicaid Services (CMS) can play a critical role in instigating change across the entire health care system.

Conclusions of the testimony recommended three important points.

First, without the alignment of financial and other incentives with both quality and efficiency goals and electronic health information exchange capabilities, efforts to accelerate the mobilization of information to support patient care will continue to move at a slow pace.

Second, innovative programs designed to facilitate public- and private-sector funding of emerging health information exchange efforts must be developed and implemented if the health IT industry wants to achieve interoperability goals. Although federal efforts can play a critical role in addressing this challenge, they should be designed to stimulate private-sector investments and state and local programs to facilitate widespread interoperability.

Third, leadership in the development and adoption of standards is critical to enable interoperability across markets. National efforts to achieve this are on target and could not be more timely. Officials should continue to recognize the importance of public/private sector partnerships, take advantage of previous field work and tackle issues on which health care officials don’t agree.

Also on Sept. 29, the House Ways and Means Committee’s Health Subcommittee heard testimony on the Medicare Value-Based Purchasing Act for Physicians, which includes structural measures related to health IT and differential payments based on quality.

The hearings quickly followed the Department of Health and Human Services Secretary Mike Leavitt’s appointment of 16 leaders -- eight from the private sector -- to America's Health Information Community, the federally chartered commission in charge of advancing the drive to reach the goal of providing electronic medical records for most Americans within a decade.

The time is ripe to leap forward in the drive to improve the quality, safety and efficiency of health care through health IT.

Marchibroda is chief executive officer of the eHealth Initiative and Foundation.