Report Announces 10 Recommendations for Future Health Information Technology

The Workgroup for Electronic Data Interchange (WEDI) has made 10 “achievable and reality-based” recommendations for the future of health information (HI) technology in a new report, released on the twentieth anniversary of WEDI’s 1993 report. The 1993 study lead to implementation of administrative simplifications of the health care information exchange in the form of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). While acknowledging the strides made in this area in the past 20 years, the 2013 report points out that the current Healthcare Efficiency Index is at 43 percent efficiency. In addition the Institute of Medicine, in 2009, noted that $360 billion was spent on healthcare administration, half of which was concluded to be wasteful. As such, the WEDI analysis identified one major problem that requires resolution: “electronically getting data to the right place(s) at the right time.”

Patient Engagement

“Patient engagement,” defined in the report as the dialogue between patients and key health care stakeholders (such as physicians, health plans, care coordinators, and public health), was an area identified as remaining “relatively suppressed.” In response to this reported suppression, the study posed questions to determine to what extent a patient could serve as a health care information center and what tools would support that notion. WEDI recommended (1) the standardization of patient identification across the health care system; (2) the expansion of health IT education and literacy for consumers so as to increase use of it; and (3) identification and promotion of effective avenues to patient information capture.

Payment Models

According to WEDI, largely as a result of the implementation of the Patient Protection and Affordable Care Act (PPACA) (P.L. 111-148), over 100 new payment models have been identified. As a part of the analysis leading up the report, WEDI conducted a survey to determine the enactment and execution issues for these new payment models. The survey revealed several potential barriers to implementation of new models including cost, infrastructure challenges, lack of interest in new models by leadership, and regulatory barriers. In response to the identified barriers, WEDI recommended developing a framework for assessing critical, core attributes for alternative payment models and the technology solutions that can mitigate the identified barriers.

Data Harmonization and Exchange

The report also calls for a departure from the past classification of health care information as either “administrative” or “clinical.” Instead the study finds that “administrative decision-making will be better served if based on information drawn directly from the clinical record, rather than abstracted according to purely administrative drivers.” To support this transition to harmonized data the report provides three recommendations for data harmonization and exchange: (1) identification and promotion of consistent and efficient methods for electronic reporting of quality and health status to all relevant entities; (2) identification and promotion of measures that would enhance care coordination; and (3) identification of methods and standards for harmonizing clinical and administrative information.

Innovative Encounter Models

Recognizing the movement away from the “one encounter” health care experience where a patient has only one encounter with one doctor in one exam room, the report notes the growing importance of email, texting, and telehealth and the consequential expansion of the normal health care processes of billing, processing, maintaining records, reporting, scheduling, and diagnosing, As such, the WEDI organization sets forth three suggestions in terms of innovative encounter models for the next generation of health IT progress: (1) identification of cases, conventions, and standards for the promotion of consumer health and the exchange of information in a mobile environment; (2) facilitating the adoption and implementation of “best-in-class” approaches which promote the spread of innovative encounters within the industry; and (3) identification of existing barriers to implementation of innovative encounters.