The Department of Health and Human Services (HHS) released a draft plan proposing four strategic areas to leverage the power of Information Technology (IT) to improve healthcare provision in the US. The public can comment on the draft until March 18, 2020.
The plan outlines four overarching goals for the use of Health IT:
- Health IT should improve patients’ health and wellness. Proposals to achieve this goal include increasing patients’ access to their health data so they can better engage in their health outcomes and improving the portability of health data for patients to carry their data across providers and seek the best care available. It also suggests for Health IT to promote healthy behavior and self-management, capture more social factors into Electronic Health Records (EHRs), and leverage individual- and community-level data to address pandemics and other public health concerns.
- Health IT should improve the experience of seeking care. Strategies to achieve this goal include educating patients regarding costs, improving price transparency, providing evidence-based automated tools to aid providers’ work, and investing in Health IT workforce development.
- A secure and data-driven IT ecosystem should allow data analytics tools, such as machine learning, to foster more individualized care as well as to improve healthcare research and management. Strategies to achieve this goal include harmonizing standards for data entry and handling so that data can be easily used for research purposes; using machine learning to develop targeted therapies; and creating a secure and uniform platform for healthcare providers on which to share.
- An interoperable Health IT infrastructure should facilitate the sharing of EHRs among healthcare providers and researchers. To achieve this goal the plan calls for promoting a competitive Heath IT sector to encourage “transparent expectation for data sharing,” to enhance collaboration among different stakeholders, and to increase the understanding by patients of their own data. The plan also calls for reducing “financial and regulatory barriers that are perceived to prevent new Health IT developers from entering and competing in the Health IT market place.” The report does not define the term “perceived” nor does it mention the regulation that gives rise to such a perception.
The plan recognizes that disparities in access to technology can exacerbate existing inequalities in healthcare access between socioeconomic groups. As a solution, it proposes to improve access of smartphones and mobile devices to marginalized communities.
The cost of healthcare in the US continues to grow faster than the US economy and remains one of the most important issues to the American public. Healthcare costs in the US are higher than in other OECD countries both per capita and as a share of gross domestic product (GDP). Yet, even though the US spends more than most OECD countries in health, it does not fare higher in some crucial health outcomes, like infant mortality and diabetes. Additionally, life expectancy in the US has decreased in recent years and rates of mental health issues in young adults are increasing.
According to the plan, Health IT provides various opportunities to improve healthcare: empowering patients with access to their health data, facilitating price transparency, facilitating the sharing of EHRs among healthcare providers while keeping the data secure, and leveraging artificial intelligence to improve diagnosis. Yet, the healthcare industry lags behind other sectors in leveraging technological advances. A 2017 study commissioned by Virtusa — an IT consulting company — concluded that “healthcare companies traditionally lag behind other industries in adopting business technologies that help with customer engagement.”
Health IT adoption, in fact, faces major challenges in the healthcare industry. For instance, the Department of Health and Human Services had previously proposed a rule to facilitate access and sharing of EHRs among stakeholders, but medical association groups and Epic (a large medical records company) have opposed that rule over unresolved privacy concerns. Studies have shown that the use of EHRs is correlated with physician burnout and a decrease in time spent with patients. The use of artificial intelligence can result in healthcare inequality. Telehealth, or virtual visits to physicians, poses various technical challenges such as reimbursement for virtual visits and presents the potential for increases in non-necessary appointments.