- Promoting clinician engagement in health IT design, improving patient identification, and closing the digital divide should be primary areas of focus for a new HHS health IT innovation and investment workgroup, according to the College of Healthcare Information Management Executives (CHIME).
CHIME issued these and other recommendations in response to an HHS request for information (RFI) released in June. The RFI solicited feedback from healthcare industry stakeholders about ways to develop a public-private workgroup intended to spur health IT innovation and investment.
The workgroup will also facilitate “constructive, high-level dialogue between HHS leadership and those focused on innovating and investing in the healthcare industry,” HHS Deputy Secretary Eric Hargan wrote in the RFI.
As part of the RFI, HHS requested suggestions for specific areas of focus the workgroup should prioritize in its discussions.
“One of the biggest challenges that the workgroup will face is identifying an effective way to incentivize or otherwise promote ongoing, responsible innovation,” responded CHIME in its letter to HHS Secretary Azar.
CHIME recommended the workgroup offer HHS recommendations for a set of standards innovators should consider when developing health IT, which HHS should use to develop a voluntary health IT innovation framework.
In developing this health IT innovation framework, CHIME suggested HHS prioritize certain ethical considerations that should be taken into account when developing and implementing technology that will affect patient care delivery.
“We believe that technology has great potential to help achieve better care and greater efficiencies,” stated CHIME. “Yet it is critical to balance the drive for innovation and use of technology with the need to ensure that innovators understand the downstream ethical considerations that will determine the extent of adoption by the end-users – clinicians and patients.”
While some ethical considerations may not be immediately apparent to health IT innovators, CHIME stated these factors are significant in determining whether a certain technology will be successful and effective.
“We recognize that this balance is often a delicate one such that innovation is not stifled, yet ethical considerations must continuously be at the forefront as technology is being developed and rolled out,” CHIME wrote.
CHIME also advised HHS to involve clinicians and patients early on in the health IT design, development, and implementation process.
“New technology can present implementation challenges that can be addressed by engaging end users early in the design phases as well as the rollout phases,” CHIME maintained. “As an example, we have a member who is using a smart speaker, which is already in widespread use in homes, in their facility. One of the biggest challenges they are encountering is how to manage patient consent with this technology.”
Involving patients and providers in the health IT development process as soon as possible can help to address challenges quickly and streamline health IT adoption and use.
CHIME also urged HHS to ensure the innovation and investment workgroup prioritizes closing the digital divide forming between large health systems and small, rural providers.
“It’s important to consider the existing gap between well-resourced providers and those with fewer resources,” wrote CHIME. “Less resourced providers who may be serving underserved and hard-to-reach patients may lack the capital to purchase cutting-edge technologies. Policies must seek to narrow the digital divide, rather than place these often small and rural providers at a further disadvantage.”
Burgeoning new technologies such as artificial intelligence (AI) may deepen the digital divide, suggested CHIME. Some large health systems may be able to afford the technology, but smaller hospitals still struggling to afford costly EHR implementations will have a harder time budgeting to keep up with new innovations in healthcare.
In addition to closing the digital divide, CHIME recommended the workgroup focus on improving patient identification.
“New technologies should support a uniform way to uniquely and accurately identify patients and connect them to their medical records – something that is a barrier to maximizing the benefits of existing and emerging technologies,” stated CHIME.
As more healthcare organizations engage in health data exchange, accurate patient identification will become increasingly important. Problems with inaccurate, mismatched, or duplicative patient health records can have a negative effect on hospital spending and patient safety.
CHIME also emphasized that new innovations should be designed with an eye toward preserving the patient-provider relationship.
“Our members are enormous proponents of technology, yet, they also understand the importance of the human touch,” wrote CHIME. “Technical innovation must flourish but it is also important to keep in mind the importance of fostering the connection between patients and their clinicians.”
CHIME stated the Promoting Interoperability initiative was a failure in this regard, and “unwittingly incentivized clinicians to spend less time with their patients and more time in front of their computer screens.”
Finally, CHIME recommended the workgroup address cybersecurity threats and streamline vetting processes.
As part of the RFI, HHS also requested feedback about who should participate in the workgroup and how the workgroup should be structured. CHIME recommended the workgroup include CIOs, providers, patients, caregivers, and EHR vendor representatives.
“CHIME appreciates the opportunity to comment and we welcome the chance to continue to help shape important policies that impact patients, providers and others in the healthcare system,” concluded CHIME.