Patient Experience, Health IT and Government

March 2015 The US Senate 1 - Stephen Melkisethian

Blog post by Colin Hung

Over the past two weeks I attended two amazing events: The Beryl Institute’s Patient Experience (#PX2015) and the Healthcare Information and Management Systems Society (#HIMSS15) conferences. At both #PX2015 and #HIMSS15 I had the honor and privilege of participating as a social media ambassador [the perfect excuse to tweet even more than I normally do at conferences].

I thoroughly enjoyed being at both events and am grateful to the organizers for the opportunity to be a part of the social media team.

On the surface both conferences couldn’t be more different. PX2015 was a gathering of people who are passionate about improving the overall experience that patients have with healthcare while HIMSS15 was a confab of everyone and anyone involved in healthIT. HIMSS15 has the equivalent of 22 football fields of exhibitor space with over 1300 vendors while PX2015 had 50 vendors in a more intimate and approachable setting.

Of course there were also similarities. Both conferences were filled with attendees who are passionate about improving healthcare. Both had fun evening events where you could get to know fellow attendees in a casual setting. Both were extremely well organized and well run.

There was however, one similarity that I found surprising. At both PX2015 and HIMSS15 there were a lot of side discussions about the role/impact of government mandates in healthcare.

At PX2015 I participated in several conversations about the CMS penalties for readmissions and the clawback for low patient satisfaction scores. There was general agreement that the intent of these reverse incentives was positive, but the impact was decidedly negative.

Inner city hospitals, for example, have high Medicare/Medicaid populations. They also have higher-than-average readmission rates because the patients they serve tend to have more than one chronic condition and low-income patients tend to use hospitals as primary care facilities. Yet because of the CMS rule, these same hospitals would see their reimbursements reduced. Thus the hospitals most in need of funding are actually struggling under the program.

At HIMSS15 there was a lot of discussion about the change made by the Office of the National Coordinator (ONC) to the Meaningful Use program (the program that helps healthcare organizations pay for the adoption of Electronic Health Record technology). On the Friday before HIMSS15, the ONC announced several significant changes to the Meaningful Use program including virtually eliminating the patient engagement requirement. In 2014, healthcare organizations had to show that 5% of their patient population view download or transmit their health data through a portal. In 2015 that requirement is reduced to just a single patient.

This change polarized the HIMSS15 attendees. On one side former ONC chief, Dr. Farzad Mostashari, called for a “day of action” to advocate for patient access to records – a call taken up by Regina Holliday, creator of #TheWalkingGallery and outspoken patient advocate, who is now planning a “Data Independence Day” to bring attention to the need for patient data access.

On the other side are healthcare organizations and associations who do not believe they can control whether or not patients actually use their portals or not. Many organizations are spending a lot of money and resources trying to attract users to their portals with no avail (a comment on their usefulness?). They see this change as an acknowledgement that patients should have access to their records, but that asking patients to actually use it is not within their control.

In both examples, the government created policies that were designed to increase patient involvement in their health and to encourage healthcare organizations to put focus on patient engagement. The question is, should the government get involved in this at all? Are these incentives necessary? Would organizations have worked on patient satisfaction/patient data access on their own? Would patient demand have been sufficient? After all, no government mandate was needed to spur the adoption of fitness trackers and now companies are finding ways to incorporate that data into electronic health records without any government incentive.

Join #hcldr on Tuesday April 21 2015 at 8:30pm ET (for your local time click here) as we discuss the following topics:

  • T1 Do healthcare organizations need the hand of gov’t to get them to focus on patient engagement/experience?
  • T2 Are government incentives/penalties effective in healthcare? (ex: Meaningful Use, Medicare)
  • T3 In your opinion what is the ideal role for government in healthcare (ombudsman? auditor? investor?)
  • T4 Is the patient voice now strong enough to affect change in healthcare? If not, how can it be strengthened?

Resources

“How to Survive CMS’s Most Recent 3% Hospital Readmissions Penalties Increase”, Bobbi Brown, HealthCatalyst, 2014, https://www.healthcatalyst.com/healthcare-data-warehouse-hospital-readmissions-reduction, accessed April 19 2015

“Hospitals underestimate threat of HCAHPS penalties”, Karen Cheung-Larivee, FierceHealthcare, March 22 2012, http://www.fiercehealthcare.com/story/hospitals-underestimate-threat-impending-hcahps-penalties/2012-03-22, accessed April 19 2015

“HHS proposed 90-day MU attestation period, easier patient engagement”, Neil Versel, MedCity News, April 10 2015, http://medcitynews.com/2015/04/hhs-proposes-90-day-mu-attestation-period-easier-patient-engagement/, accessed April 19 2015

“Mostashari wants ‘day of action’ for widespread patient access to records”, Neil Versel, MedCity News, April 12 2015, http://medcitynews.com/2015/04/mostashari-wants-day-action-widespread-patient-access-records/, accessed April 19 2015

“Regina Holliday: We’ll fight Meaningful Use Stage 2 with a Data Independence Day (video)”, Chris Seper, MedCity News, April 12 2015, http://medcitynews.com/2015/04/regina-holliday-mad-hell-meaningful-use-2-heres-shes/, accessed April 19 2015

“DeSalvo reiterates ONC’s commitment to health consumer empowerment”, Neil Versel, MedCity News, April 14 2015, http://medcitynews.com/2015/04/desalvo-reiterates-oncs-commitment-health-consumer-empowerment/, accessed April 19 2015

“The roles of government in improving health care quality and safety”, Tang N et al, Joint Commission Journal on Quality and Safety, January 2004, http://www.ncbi.nlm.nih.gov/pubmed/14738036, accessed April 19 2015

“Pew Research on the Government’s Role in Health Care”, Don McCanne MD, Physicians for A National Health Program, June 13 2014, http://pnhp.org/blog/2014/06/13/pew-research-on-the-governments-role-in-health-care/, accessed April 19 2015

“What role should the government play in the healthcare of its citizens?”, PBS Newshour, November 28 2013, http://www.pbs.org/newshour/bb/government_programs-july-dec13-aca_11-28/, accessed April 19 2015

Image Credit

March 2015 The US Senate 1 – Stephen Melkisethian

https://flic.kr/p/qLRBbw

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3 comments

  1. Is there a Storify or other recap for the Twitter chat on this topic? I know someone who would really like to read it.

    1. Hello Angelique. This is Colin. No Storify just yet. With all the #HIMSS15 craziness I simply haven’t had time to go back and make one. It’s definitely on my to-do list. Will ping you when it is available.

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