Guest post by Justin Sotomayor, pharmacy informatics director, CompleteRx.
The field of health informatics has grown exponentially over the past 50 years. From Robert Ledley’s work paving the way for the use of electronic digital computers in biology and medicine in the 1950s, to the founding of the American Medical Informatics Association in the 1990s, to the launch of the Medicare/Medicaid Electronic Health Record Incentive Program in the 2000s, it continues to mark new milestones at an astounding pace, presenting both challenges and opportunities for the healthcare industry.
Three trends – in particular – will have a marked impact on patients and practitioners, and are certain to define health informatics in the near future, if not for years to come.
The end of Meaningful Use
In 2009, with the passing of the Health Information Technology for Economic and Clinical Health (HITECH) Act, came the launch of the Meaningful Use program – and the related requirement that healthcare providers show “meaningful use” of a certified EHR to qualify for incentive payments. With both Stage 1 (adoption) and Stage 2 (coordination of care and exchange of information) behind them, hospitals are fully responsible for Stage 3 (improved outcomes) by 2018. While, undoubtedly, the program has improved EHR adoption – in many cases, streamlining and enhancing patient care – it has been widely criticized. In a 2015 news release, the American Medical Association regarded Stage 2 as a “widespread failure,” suggesting it monopolized staff attention without commensurate benefit to patients, and hampered innovation.
Most recently, following highly-publicized remarks in January by CMS Acting Administrator Andy Slavitt that Meaningful Use would be replaced, the U.S. Department of Health and Human Services has proposed transitioning Meaningful Use for Medicare physicians to the “Advancing Care Information (ACI)” program under the Medicare Access and CHIP Reauthorization Act (MACRA). According to Mr. Slavitt, this program is designed to be “far simpler, less burdensome, and more flexible,” primarily by loosening the requirements to qualify for extra payments, and incentivizing providers based on treatment merit, known as Merit-based Incentive Payment System (MIPS). While this update doesn’t yet affect hospitals or Medicaid providers, and these groups should continue to prepare for full Meaningful Use implementation, it’s an indication that industry concerns over meaningful use are being heard and responded to, and that additional changes may be forthcoming.
Today’s medical devices feature the most cutting-edge technology and sensors to improve patient health, from Fitbits that track heart rate during exercise to devices that can test and display blood glucose levels on a smartphone. Healthcare professionals have also welcomed the use of smart devices and tablets to enhance hospital or clinic visits, lower costs and reduce medical errors.
The demand for health informaticists grows substantially with every government push to adopt technology and ease the switch from paperwork to electronic health records (EHR) systems. To ensure the next generation of health informaticists are learning the skills needed to adapt as technology advances, many universities are offering a health informatics degree program that emphasizes hands-on learning in health IT, data analysis and the healthcare system.
Here’s a look at what a formal education in health informatics looks like today, and what in-demand skills employers can expect from health informaticists down the road:
Health Care System Analysis and Assessment Outcomes
Improvements to the healthcare system begins with a thorough understanding of what the current system lacks. Today’s health informatics courses allow students to examine healthcare needs and analyze the supply and distribution of health professionals and facilities. These courses also explore current industry pain points, particularly care costs, how to assess care quality, and the financial models of care used in both private health insurance systems and government programs.
Health informatics students are also familiarized with methods for determining quality of care and the economic impacts of health care models. Courses examine the outcomes and value added from the view of patients and providers, with a focus on determining standards for setting organizational policy.
Health Care History and Implementation of EHR Systems
To understand the role that health informatics plays in improving the healthcare system, students also cover the history of the U.S. healthcare system. By exploring current trends in electronic health records – including social, ethical, economic and cultural impacts of choices – students will be prepared to identify what improvements can be made to EHR systems later in their careers as health informaticists.
The Affordable Care Act supports healthcare providers in reducing costs and improving efficiency while delivering quality care. Accountable care organizations (ACOs) achieve these goals by enabling physicians, hospitals and other healthcare providers to create networks and share responsibility to deliver care to Medicare and other patients.
At the heart of the ACO model are three core principles:
ACOs are provider-led organizations with a strong primary care base, and collective responsibility for quality and per capita costs.
ACO payments are linked to improvements in quality that also reduce costs.
Performance measures that support improvement are sophisticated and reliable, and demonstrate that savings are achieved through improvements in care.
Joining an ACO is voluntary, but the federal government encourages participation to reduce unnecessary or duplicated services, prevent errors and keep patients healthier. When providers successfully coordinate services to meet a long list of quality measures, they become eligible for bonuses.
The Current Environmment
Medicare offers several ACO programs, including the Medicare Shared Savings Program, the Advance Payment ACO Model and the Pioneer ACO Model, but many other public and private models exist. Some are sponsored by physicians groups, while nonprofit organizations, hospital systems and health insurers sponsor others. The Pioneer Model was designed for early adopters of coordinated care, and is no longer accepting new members.
To date, more than 600 public and private ACOs have formed; in 2012, the first year of the program, they generated $87.6 million in gross savings. Government support is spurring considerable growth, and ACOs could well become the dominant model in healthcare.