Lauren Fifield

2014: Health technology becomes reality

December 05, 2013
By Lauren Fifield

Across the spectrum of policymakers, entrepreneurs, investors, and everyday Americans, all eyes are on health care. And for most, the big question is whether the recent onslaught of technology and policy initiatives will lead to meaningful, and much needed, change. While much has happened in 2013 to affect health care delivery, this year serves as a warm-up to 2014, a year during which we’ll see even bigger shifts. From the implementation of ICD-10 to new Meaningful Use requirements to the expansion of accountable care and other value-based payment models, this year’s trends will be more fully realized and their impact will be amplified within the shifting EHR market.

While the coming year is likely to bring disruption in key sectors of the health care economy, this disruption is also poised to yield big gains in efficiency and effectiveness among providers and health technology vendors alike.

Whatever happens in the broader health policy context, there is an unstoppable trend towards greater EHR adoption that will continue to grow as providers face Meaningful Use penalties if they do not participate in 2014 and new payment models that increasingly rely on measurement and reporting by technology. Accountable Care Organizations and other models of value-based care require the effective use of electronic health record technology — without it, outcomes-based reporting and care improvement is burdensome and inaccurate. Between the positive incentives of new payment models and the negative pressure of Meaningful Use, EHR adoption is poised to grow significantly in the next year.

The implementation of ICD-10 presents a whole new reason for providers to adopt effective EHR solutions. While often thought of as a billing issue, advanced and cloud-based EHR solutions will offer providers tools that allow them to more easily transition from ICD-9 to ICD-10 by integrating translation tools into their clinical workflow and connecting to billing solutions for efficient transfer of data for reimbursement. These kinds of tools will greatly reduce the burden on providers who are anxious about the impact that ICD-10 will have on their workflow.

EHR dissatisfaction among providers is as high as it’s ever been, especially as Meaningful Use Stage 2 requirements begins to underscore the lack of viability among many EHR vendors. Among the more than 900 EHRs certified for Meaningful Use Stage 1, only 72 complete EHRs have been certified for Stage 2 so far. One in three practices are already dissatisfied with their existing EHR, half of whom plan to switch in the next year.

While this will mean disruption for practices that plan to switch in the short-term, the ultimate advantage is that the remaining EHRs on the market will be better able to evolve in an industry of rapid change. Furthermore, those solutions will be more effective, more efficient, and easier for providers to adopt. With clear alternatives, the EHR vendors that emerge will have greater pressure to provide better features at lower costs, leading to cheaper options for providers who have resisted the high cost of adopting traditional EHRs.

Independent practices will become more networked
Between the rise of EHR adoption and the emphasis on interoperability with Meaningful Use Stage 2, smaller practices will soon have more tools to connect and coordinate their care efforts. EHR technology will not only allow them to participate in value-based payment initiatives that can drive more effective care, but it will also allow them to actually coordinate care within ACOs and other organizations in a meaningful way. Standards for and the ubiquitous availability of physician-to-physician and physician-to-patient messaging functionality for Meaningful Use Stage 2 will lay a foundation for improved patient engagement and innovative payment models. Further, advances in connectivity between independent practices and important partners, such as laboratories and imaging centers, will further improve care coordination activities with integration into the clinical workflow and reduction of errors and administrative burden.

While the change ahead poses challenges to these practices – especially those facing Meaningful Use pressures and the need to switch EHRs – this coming year will also bring major refinement of the technologies and approaches that providers have implemented in their practices. As a result, we’ll see independent practices providing more innovative, more networked, and higher quality care—all the promises of health technology, at last realized.

About the author: As Senior Health Policy Advisor at Practice Fusion, Lauren Fifield manages government relationships and monitors an ever-changing landscape of legislation, regulation, and health industry antics. She advocates for policies that promote the transformation of health care delivery through innovation in health IT and serves on the Executive Committee of the Electronic Health Record Association. Before joining the team, she managed health policy and government affairs for athenahealth, Inc., a provider of web-based software and services to ambulatory providers.