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Value-Based Care to Require New EHR Selection Tools, Resources

Value-based care will increase demand for certified EHR technology, but health IT comparison tools are found wanting.

By Kyle Murphy, PhD

The implementation of value-based care models, notably MACRA, in coming months will bring with it increased demand for certified EHR technology (CEHRT), but a lack of reliable information to compare health IT products and services could undermine the EHR selection process.

That's the conclusion the Office of the National Coordinator for Health Information Technology ultimately draws in an April report to Congress on the tools currently available to healthcare organizations and providers for comparing and selecting CEHRT products.

"As health IT continues to evolve to play an integral role in care delivery and patient engagement, the need for comparison tools will increase as adoption expands to provider groups with little or no exposure to the technology as well as those upgrading current technology to meet these needs," the report states.

"Furthermore, as the health care system moves toward value-based reimbursement," it continues, "there will be a greater need to ascertain whether certified health IT products provide the functionalities that support quality improvement, clinical quality measures, reporting and related features."

At present, the healthcare industry lags behind others in having recourse to comparative information about EHR usability and cost.

"If, however, providers could compare and select certified health IT on the basis of usability and cost, in addition to functionality, health IT developers might begin to compete on those factors. Such competition could lead to innovations in the field of certified health IT usability, leading to improvement in providers’ experiences with their certified health IT systems," ONC claims.

The federal agency does note that health IT comparison tools prove most beneficial when coupled with an effective health IT implementation and adoption strategy.

There must also be an understanding in the health care community that improving comparison tools cannot be the only solution towards the safe and efficient provision of health care, since optimal certified health IT use is more complex than selecting the right system for the practice’s needs. Optimal certified health IT use is also dependent on proper end-user training, a comprehensive implementation strategy, and a variety of other factors that ensure the safe, efficient use of certified health IT products.

ONC is recommending four mechanisms to address gaps in health IT comparison tools.

Mechanisms for improving health IT comparison tools

According to the division of the Department of Health & Human Services (HHS), these tools will prove beneficial to all providers, but most especially for providers small, rural, and under-resourced practices as a result of a prevailing lack of technical expertise and financial resources among these types of providers.

These health IT comparison tools will serve more than first-time buyers considering how EHR use and design evolve over time, ONC adds.

"In the lifecycle of certified health IT adoption and implementation, a provider’s need for a certified health IT comparison tool continues beyond the acquisition of their first certified health IT product," it writes.

Health IT implementation, adoption life cycle.

In line with the four mechanisms the federal agency has laid out, ONC also detailed forthcoming changes to its Certified Health IT Product List — the new, open CHPL — this spring:

The open data CHPL will provide more easily searchable data access to a wide array of data elements captured during the certification process. These data will be available for all health IT certified to 2015 Edition certification criteria or 2014 Edition health IT certified in 2016 and later, and will be available for export using common standard file types. This open access will include, among other information about certified health IT, additional software requirements the system needed in order to achieve certification, the clinical quality measures to which the certified health IT was certified, certain user-centered design testing results, links to product disclosures made by health IT developers, and, as applicable, any corrective action information resulting from ongoing surveillance activities.

Later this year, ONC will additionally release a Health IT Playbook to provide technical assistance small and medium ambulatory practices.

Ultimately, the goal is to ensure that providers have the tools necessary for succeeding in a value-based care ecosystem.

"As the variety of health IT products increases, health IT comparison tools will become increasingly critical to the provider community in the near future. Improving comparison tools’ functionality and utility is only one component in ensuring providers have health IT that supports safe, efficient, and effective care," says ONC.




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