Leavitt looks local for health IT linchpin

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ORLANDO–Michael O. Leavitt, Secretary of Health and Human Services (HHS), took center stage at the 2008 HIMSS conference Tuesday morning to deliver a keynote address highlighting the importance of deploying high-end healthcare IT systems, such as electronic health record (EHR) products, to small- and medium-size primary-care physician practices in the United States.

“Technology adoption requires sociological change,” Leavitt said.

In support of this declaration, the Secretary shared his experience spearheading a “smart” driver’s license initiative when he served as governor of Utah. The program, which promoted the embedding of a computer chip containing information about the license holder in the document, was ultimately derailed by concerns about privacy and possible misuse of information.

Leavitt’s take-away from the smart-license proposal was that “people intuitively do not trust bureaucracies; they trust what they know and who they know.”
 
“Trust is something that’s built locally,” he said. “It needs to be built into every digital packet. It needs to be based on long-observed principles that have guided our efforts in privacy for decades. Trust is achieved one heart and one mind at a time.”

An extension of this one heart, one mind philosophy is Leavitt’s Medicare demonstration project, initiated in late October 2007, which offers incentives to primary-care physicians to use EHRs.

Over a five-year period, the program will provide financial incentives to physician groups using Certification Commission for Healthcare Information Technology (CCHIT) certified EHRs to meet certain clinical quality measures.  A bonus will be provided each year based on a physician group’s score on a standardized survey that assesses the specific EHR functions a group employs to support the delivery of care.

“The demonstration is designed to show that streamlining healthcare management with electronic health records will reduce medical errors and improve quality of care for 3.6 million Americans,” Leavitt said. “By linking higher payment to use of EHRs to meet quality measures, we will encourage adoption of health information technology at the community level, where 60 percent of patients receive care.

“We also anticipate that EHRs will produce significant savings for Medicare over time by improving quality of care,” he said. “This is another step in our ongoing effort to become a smart purchaser of healthcare—paying for better, rather than simply paying for more.”

Conducted by the Centers for Medicare and Medicaid Services (CMS), the demonstration is open to participation by up to 1,200 small- and mid-size physician practices. Over a five-year period, the program will provide financial incentives to physician groups using CCHIT-certified EHRs to meet certain clinical quality measures. A bonus will be provided each year based on a physician group’s score on a standardized survey that assesses the specific EHR functions a group employs to support the delivery of care.

The CMS demonstration also will help advance Secretary Leavitt’s efforts to shift healthcare in the U.S. toward a system based on value. HHS is working to effect change through its value-driven healthcare initiative, which is based on four cornerstones: interoperable electronic health records, public reporting of provider quality information, public reporting of cost information, and incentives for value comparison.

“Broad adoption of electronic health records has the potential not only to improve the quality of care provided, but also to transform the way medicine is practiced and delivered,” he said.