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Success of Value-based Care Depends on Clinician Data Access

The outgoing heads of ONC and CMS see clinician data access through advanced healthcare interoperability as key to achieving value-based care.

Value-based care

Source: Thinkstock

By Kate Monica

- The old guard is making way for the new at the Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC). The heads of the two federal agencies are stepping down but not before offering advice to their successors for improving clinician access and use of health data to improve care coordination and quality.

In a recent CMS blog post, National Coordinator Vindell Washington, MD, MHCM, and Acting Administrator Andy Slavitt outlined a roadmap for the incoming administration to follow in its continued pursuit of industry-wide interoperability.

As the two note, a secure, accessible, and cumulative electronic health record will improve overall patient care during, before, and after visits. A hospital functioning according to a value-based payment system, ideally, promotes data access and exchange as the central nervous system of its operations.
Increased EHR implementation over the past several years has demonstrated numerous benefits, but certain obstacles still bar providers from a fully data-driven healthcare system.

“While the tools are improving, some clinicians remain frustrated by the limited usability of their technology and data, from their inability to easily enter and access key information when and where they need it at the point of care to challenges in accessing timely feedback on the quality of care in their practice. We need 21st century information technology, enabling ready and secure data access, to support a modern, value-based healthcare system,” Washington and Slavitt wrote in their joint blog post.

Among the obstacles hindering the full implementation of a value-based care system are the number of payers providers interact with on a day-to-day basis. The pair acknowledged that Medicare is not the only payer providers are dealing with. At this point, the average physician works with twelve different insurers.  

The number of different payers providers work with impede access to data across disparate payers, obstruct actionable insights to inform care, and present clinicians with increased administrative challenges — among other obstacles.

Along with easing provider dealings with an array of payers, HHS also seeks streamlined quality reporting and minimized financial and administrative burden of collecting and reporting information on the part of the provider.

In an effort to surmount these challenges and promote value-based care, HHS has outlined a plan enabling clinicians to gain access to actionable feedback data regardless of payer. CMS outlines six essential elements to ensure a value-based health care system that focuses primarily on improving patient care.

Improved relations between point of care solutions and other entities through the use of APIs: Washington and Slavitt suggest Health IT developers work toward innovating APIs promoting data exchange between EHRs and other services, including registries.

Development of third-party entities able to meet provider data access and reporting needs: By encouraging a thriving marketplace of developers specializing in enabling core functions, including facilitating accurate reporting to payers, providers can introduce new innovations and fresh ideas from a variety of sources into the healthcare industry.

Implementation of low-cost shared services useful for collecting and connecting data: Encouraging stakeholders to create new means of streamlining the process of obtaining data to correctly match patients to their providers is necessary for a value-based payment system. CMS recommends stakeholders connect over shared governances and financing for these services to ensure everyone is operating along similar lines.

Increased data transparency and data consolidation: Aggregating data into one place can make things easier for stakeholders looking for information and decrease challenges for payers interested in making their own data accessible for outside entities.

Standardization of patient data necessary for quality measurement: Standardizing data for measures and developing tools helpful in this endeavor, including libraries of data elements facilitating clinicians and consumers in their efforts to obtain, calculate, and report information.

Alignment around how quality is measured and reported across payers: By aligning around a common standard for quality measures and reporting mechanisms, payers can improve performance feedback for clinicians and increase clinicians’ opportunities to compare feedback in a productive, legible way.

With these six points in mind, HHS anticipates progress toward interoperability on all fronts and an improved health IT infrastructure ultimately aimed at improving overall patient care. 

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