In a June 15 letter to Congress, representatives of the College of Healthcare Information Management Executives, a group comprised of more than 1,400 CIOs and other senior information technology executives at hospitals and clinics nationwide, highlighted ways that a legislative focus on interoperability and telehealth could improve chronic disease management.
The letter, written by Russell Branzell, president and CEO of Chime, and Charles Christian, chairman of the CHIME board of trustees, covered three broad subsections of recommendations for the Senate Committee on Finance.
1. The implementation of policies related to longitudinal EHRs that will be invaluable resources for care coordination.
2. The standardization of federal telehealth policies, which lag behind those of both state and private payers. These inconsistencies in the definition and reimbursement policies regarding telehealth services are hurdles to widespread adoption.
3. Efficient use of patient and provider resources, patient and caregiver education, and monitoring vital signs and patient activity remotely or in the acute setting are among many aspects of the healthcare equation that stand to be improved through a more health IT-oriented focus.
Here are 13 key recommendations from the three subsections of CHIME's letter to Congress.
1. Enhance health data exchange
• In order to reduce waste and improve quality within the U.S. healthcare system, a high degree of data fluidity is imperative.
• The Committee should pursue policies with the intent to increase the exchange of health data, facilitating the compilation of a longitudinal healthcare record that will enable informed decision making for both providers and patients.
• The concept of this longitudinal healthcare record should reflect the patient's experience across episodes of care, payers, geographic locations and stages of life.
• This record should consist of provider-, payer- and patient-generated data. It should be accessible to all members of an individual's care team, including the patient, in a single location.
2. Rethink federal telehealth policies
• Telehealth technologies can offer benefits to hospitals and health systems such as the ability to perform high-tech monitoring without requiring patients to leave their homes.
• Telehealth services can include post-discharge remote monitoring programs or remote video consultation for emergency departments that enable telepsychiatric screening.
• Telehealth services have been shown to reduce the rate of readmission, lower costs and increase patient satisfaction by fostering convenience.
• A possible barrier to standardizing the provision of valuable telehealth services is whether or not public and private payers cover telehealth services.
• CHIME requests that the Committee consider how the CMS Innovation Center is poised to evaluate how a resource like telemedicine can be incorporated into alternative care and payment models.
3. Patient engagement
• Time is one of the most common limitations of physical-presence healthcare. Patients' time pressures and providers' time limitations have been well documented and can lead to forgotten questions and concerns.
• Telemedicine communications, using currently available handheld internet-ready technologies are adequate for effective and high quality patient-provider interaction.
• These systems enable information to be exchanged in a bidirectional fashion at separate times and often result in a more satisfying and productive exchange.
• The adoption of remote monitoring technologies has increased, especially as the market for fitness trackers and wearable devices continues to thrive.
"The Committee should consider ways to leverage the ongoing Medicare and Medicaid Health Record Incentive Programs and the meaningful use program as a method to ensure Medicare and Medicaid providers have EHR systems that are capable of exchanging patient data by both the patient and other providers," Mr. Branzell and Mr. Christian conclude in the letter.
They write that the need to address the technical complexities is paramount, and they ask that the committee support policies to encourage the development and widespread adoption of standards for capture and exchange between remote medical devices and health IT systems.