This edition of the podcast highlights some of the key perspectives from attendees at the 2019 Healthcare Information Management Systems Society, or HIMSS, Annual Conference. At this year’s conference, Administrator Seema Verma gave two keynote presentations on the agency’s vision for the future and its focus on interoperability.
Voice Over (VO): Welcome to the CMS Beyond the Policy podcast. This edition of the podcast will highlight some of the key perspectives from attendees at the 2019 Healthcare Information Management Systems Society, or HIMSS, Annual Conference. At this year’s conference, Administrator Seema Verma gave two keynote presentations on the agency’s vision for the future and its focus on interoperability. CMS also held several educational sessions and engaged with a high-volume of attendees at its exhibit booth. This allowed CMS subject matter experts to discuss the agency’s quality programs and initiatives, as well as seek input from clinicians, health care organizations, health IT vendors, and others in the health care community on how to enhance these programs and initiatives.
VO: Following Administrator Verma’s morning keynote, we spoke with some of the session attendees to get their feedback on CMS’s direction moving forward. First we’ll hear from Bradley Saull from the Professional Services Council, an industry association that represents government contractors.
Bradley, what remarks from Administrator Verma’s presentation resonated with you?
Bradley Saull: I think the importance of the rule that was out yesterday as a key part of what resonated with me with the panel presentation today. You can really see all the four panelists, how they all built off of each other, what the Bush administration did, what the Obama administration did, and now what the Trump administration is doing to promote the successes of blue button, FHIR standard, and the interoperability of, really, a call to action for the private sector innovate and work with government. I think something that our organization deals with every day is getting government and industry to work together to achieve more, and so I think the approach that CMS is taking to try to bridge the gap between government and industry and to improve outcome for patients is a tremendous goal.
VO: Great. So, what other innovations do you think could disrupt the healthcare marketplace?
Bradley Saull: Well, certainly a lot of emerging technologies are being discussed out there as a way to disrupt and improve the patient experience and all of healthcare, so things like AI and analytics and certainly unlocking some of the information that CMS has as a big payer and working with the exchanges and the variety of different patients that provider organizations are going to be tremendously helpful going forward in the future, and I think CMS and the private sector are ready to work together.
VO: Bradley, thank you for taking the time to speak with us. We really appreciate it!
Now we’ll hear from Dr. Robert Heizelman a family physician and clinical informaticist with Bon Secours Mercy Health.
Dr. Heizelman, what were your thoughts on Administrator Verma’s remarks?
Dr. Robert Heizelman: I think specifically the remarks are about claims data now being mandated for information exchange. I think there's a golden opportunity there to identify whether or not patients have had unnecessary health maintenance such as a mammogram or a colonoscopy just simply by a billing code, which would be helpful, and then a clinician could go down and look for the results or the pathology reports. But, really, at the end of the day, it is all about interoperability and health information exchange.
VO: So, along the same lines, what do you think CMS needs to do to continue to advance healthcare and put patients at the center of care?
Dr. Robert Heizelman: I think your question identified the answer, and that is putting patients at the center of care. During the course of the discussion earlier, they talked about data ownership. Quite frankly, there's only one person that owns the data, and that's the patient, and that information should be used in the best interest of the patient, and as a physician, I can make the best clinical decision if I have a complete information set.
VO: Thank you so much, Dr. Heizelman. It’s been a pleasure speaking with you.
Now our next interview comes from Laurie McGraw with the American Medical Association. Laurie, what are your thoughts on Administrator Verma’s remarks and what do you think CMS should do to continue to advance healthcare and put patients at the center of care?
Laurie McGraw: Well, I like the comments very much on reducing physician burden, being from the American Medical Association, and I think that these efforts to remove information blocking and data blocking are going to be a great step forward for the industry.
I think that these efforts underway are good ones and great steps forward. I really enjoyed the panel's comments. I like how they wove other efforts from before and are integrated in moving them forward, and I think that all efforts to reduce burden on physicians in the care of patients is extremely important, so I applaud the work.
VO: Thank you so much for your time, Laurie.
Wow, we have already heard some great feedback on Administrator Verma’s presentation! Let’s keep it going. Next, Lonnie Rae, CEO at Medal shares her input on the presentation and what she thinks about consumer-directed exchange.
Lonnie Rae: As someone who's been working in healthcare and who has also experienced a lot of this firsthand, I've seen so many patients who come in without their health records, without the information we need to treat them, and then when you receive that information, it's incredibly hard to understand what's in it in a glance. So if you have 15 minutes to decide how to treat someone who's in your emergency room, being able to quickly get a view of all of the applicable information is incredibly important, and figuring out not just a way to rule out and eliminate faxing, but find the technology to appropriately fix that is going to have a huge effect on our delivery of healthcare.
Consumer-directed exchange is going to be the way of the future. It's important to have the patient in the loop. It doesn't make sense for you to have a bank account that everyone can access but you.
VO: We couldn’t agree with you more Lonnie. Thanks for taking to time to speak with us today!
For our last interview, we are pleased to speak with Michael Nusbaum, Vice Chair of the HIMSS North America Board to get an international perspective on the Administrator’s presentation.
Michael Nusbaum: Well, I was part of the journey from the very beginning, and I just -- the progress that's been made incrementally, which she highlighted, has really resonated with me. We've built a baseline, but it wasn't enough. Government took action and led and incented the community to do some things, but that wasn't enough. We saw lots of activity in the EHR space with hospitals and doctors, but that wasn't enough. And now there's a recognition that the whole continuum of care is being brought into this, including the payer community and other communities, and that, to me, is getting to the goal line, and that really did resonate with me, so I really am excited about the next phase.
VO: It’s been a pleasure, Michael. Thank you for your time and feedback.
We’ll hear more from attendees after Administrator Verma’s second keynote speech on interoperability and patient engagement.
VO: For her second and final keynote presentation, Administrator Verma closed out the opening day of the conference with a presentation that focused on the new CMS Interoperability Rule and patient engagement. Let’s listen to a few highlights from her speech now.
Administrator Verma: “So, last year, we took great steps to deliver on our promise, but they were just the beginning. And I'm extremely proud to announce that yesterday CMS furthered our efforts to empower patients through the Interoperability and Patient Access Proposed Rule.
This rule has policies that touch just about on every entity that CMS regulates, from health plans to hospital and clinicians to post-acute-care providers. We want every stakeholder focused on the need for seamless data sharing. And last year with Blue Button 2.0, we provided access to claims data for nearly 40 million Medicare beneficiaries. And now we're requiring that other insurers follow our lead.
For the first time, we're proposing that all health plans doing business in Medicare and Medicaid and through the federal exchanges share health-claims data and other important information electronically with their patients. With all of those plans on board, by 2020, 85 million patients will have access to their health-claims information, in addition to the nearly 40 million beneficiaries in traditional Medicare who already have access through Blue Button 2.0. Beneficiaries will now have access to electronic claims data, including pricing information... [ Applause ] ...that can be aggregated in one place. And patients should be able to take their data as they move throughout the healthcare system from doctor to doctor and plan to plan. Just because a patient changes plans, that shouldn't mean that they lose access to their health history. And in an age where information is just a click away, patients must have easy access to their own cumulative personal health information. And applications that support this are already here, thanks in part to our Blue Button 2.0 app developers. And having access to newly available claims data will fuel adoption and drive the sharing of data.
But even with empowered patients, we need the healthcare system to have data-sharing and notification abilities in place. In our new proposed rule, we are improving the experience for patients and providers when transitioning between settings. As a condition of participation in Medicare, which is the strongest lever that we have, we are proposing that hospital must electronically notify providers and a patient's care team whenever a patient is admitted, discharged, or transferred to another care setting.
This is a small step in improving the discharge process for patients and their care teams, but it's a significant first phase of the policies that we are proposing. And looking forward, we want to see a future where it's more than a notification at discharge. Instead, the entire records set will follow the patient.
We will not stop until we ensure that patients will always be able to get their records, to utilize them and share them as they wish, not only for patient empowerment, but because the future of our healthcare system depends on it, for data is the fuel of healthcare innovation. Ultimately, we all need to work together to drive this seamless flow of information across the healthcare system. And as I've said, that means a healthcare future where patients are able to obtain and share their healthcare data securely and privately with just a few clicks. That's a future that truly empowers patients and is the beginning of the digital data revolution.”
VO: Now we’ll hear from some of the attendees to get their insights and feedback on what they heard from Administrator Verma about the proposed rule.
First, Linda Van Horn of iShare Medical. Linda, after today’s presentation, how do you think CMS can further promote interoperability?
Linda Van Horn: I'm very excited by the comments that the secretary made, and more importantly by the fact that they're taking action. I'm excited by the proposed rule that just came out yesterday, empowering patients to get access to their data because I truly believe that patient engagement is going to drive down the cost of healthcare and empower patients to improve care and outcomes.
VO: It’s great to hear that her presentation was encouraging to you! With advances in the healthcare field there are always barrier that arise. What do you see as the barriers that continue to hinder interoperability and how do you think CMS can help remove those barriers?
Linda Van Horn: I think there's a lot of barriers. There's misunderstanding, I think, about HIPAA, especially at the team level and doctor's offices and hospitals where they might misuse HIPAA, thinking that HIPAA violation is actually a problem when it actually doesn't exist or it's used as an excuse, and I also think that some people are afraid of sharing the data, and when it comes to bidirectional exchange of data, I also think that a lot of health systems are concerned about letting access to other data into their health system, but if we're going to move the ball forward, I agree with Secretary Verma's comments about the need for being able to do bidirectional exchange of information and create that healthcare record of all the medical records from all the providers in one shareable view.
VO: Linda, thank you for sharing your thoughts with us.
Let’s hear final thoughts on the day from Zach Finn of HIE Networks in Tallahassee, Florida, who shares his thoughts on interoperability.
Zach Finn: I think -- I've been doing this for over a decade. This is the first time I've actually gotten a little excited for the response from the CMS administrator, to put it bluntly, calling out the electronic medical record vendors on siloing the data. It's been a known issue in this industry for a long time, so I'm encouraged to actually see if it happens. So time will tell.
VO: Thank you, Zach! What a great way to conclude our interviews for the day. Thanks for speaking with us.
That’s a wrap from HIMSS19 in Orlando, Florida. Thank you to all of today’s interviewees and to our audience for listening.