The 21st Century Cures Act wasn’t just about speeding along the approval process for pharmaceuticals. It may also speed along the advancement of interoperability of electronic health records and put an end to data blocking.
To go over some of the policy victories for health IT within the law, including the extra funding for major IT initiatives, HealthExec spoke with Alan Portela, CEO and board chairman of mobile interoperability platform AirStrip.
HealthExec: Interoperability has been elusive for some providers. How will extra funding within the 21st Century Cures Act advance interoperability and not just throw money at the problem?
Portela: In combination with the new administration and the bipartisan support for the Medicare Access and CHIP Reauthorization Act, the Cures Act will give full authority for HHS to take a fresh look at fixing past mistakes and defining the immediate requirements for interoperability. The bill will force vendors to open up their existing APIs. This will quicken their compliance efforts for interoperability standards and also improve those standards to look beyond EHRs, to include medical device data and other sources.
HealthExec: What parts of the law will have the bigger impact on health IT—the extra money or the regulatory changes?
Portela: The biggest contribution for the health IT industry is the funding of $4.8 billion to the National Institutes of Health to help advance the precision medicine initiative aimed at driving technology-enabled personalized medicine. The law will help by ensuring EHR data - as well as data from other clinically relevant sources such as medical devices - are interoperable and secure for seamless communication between patients, physicians, and the rest of the care coordination team. If we only rely on the current limited interoperability standards and the publicly announced plans from legacy vendors to comply with those standards, we will not be able to move towards precision medicine.
HealthExec: It also includes new fines for information blocking. Do companies take notice and change their methods based on those kinds of penalties?
Portela: In the Meaningful Use program, interoperability and cybersecurity were overlooked while everyone focused on the adoption of EHRs. This oversight created the biggest data blocking and vendor-controlled, siloed environment ever experienced in healthcare.
The real challenge today is not that legacy companies do not have the technical ability to share data - on the contrary, their systems are very capable of supporting interoperability. Data blocking occurs by design in order to protect customer silos. Some companies are starting to show signs of hope.
Meaningful Use incentives represented the carrot, now we need to quickly enforce the penalties – the stick.
HealthExec: For health IT vendors like yourself, what kind of opportunities does the law create? What kind of solutions will providers be looking for because of the Cures Act?
Portela: AirStrip had a vision for the past five years of creating a ‘single pane of glass’ clinical dashboard that allows caregivers to make the right decisions on a real time basis. We recognized back then that relevant data aggregation and visualization needed to go beyond EHRs to include medical device data, imaging and eventually patient specific data - genomics, behavioral, and so on.
The industry was shifting from a hospital-centric model to a patient-centric model and eventually to a person-centric model, or what we call personalized medicine today. Our systems were designed to support this transformation.
However, what I underestimated was the data blocking by legacy vendors since I assumed we were all doing this for the right cause. The solutions and opportunities are there and the transformation will occur when the government intervenes; after all, the government created the problem so now they need to step in and help.
HealthExec: Is there anything the health IT sector wanted in this law that it didn’t get?
Portela: It falls short due to a lack of clarity on how they are planning to enforce interoperability beyond limited standards, beyond EHRs and methodology on how data will be protected.
HealthExec: Is there anything in the law which specifically effects mobile applications?
Portela: We need to realize that mobile technology is no longer the buzzword, as it is only an enabler of clinical transformation. We also need to realize that there are a number of additional mission-critical enablers - such as cognitive computing, clinical decision support tools, cloud computing and care communication tools - that are essential in an environment where the shortage of caregivers is extreme.
What we like the most about the law is that it places the emphasis on real challenges of population disease management for cancer, mental health and the like, and takes a personalized medicine approach around precision medicine.