David Brailer: Current method of HIT regulation 'faulty,' unsustainable
While health IT has the ability to enable high-value care, its potential has yet to be reached on a broad scale due to a number of different factors, most notably inefficient government policies, according to several industry stakeholders who spoke at an event Wednesday in the District of Columbia hosted by Brookings.
For instance, former National Coordinator for Health IT David Brailer (pictured right), who now serves as managing partner and CEO at investment firm Health Evolution Partners, called the current architecture of health IT regulation, which focuses on regulating providers, a "very faulty model" that is not sustainable in the long term.
"Last year, health IT had a record investment from venture capital firms--$4.1 billion--and the numbers are growing tremendously," Brailer said. "Everyone thinks about the patient and how to organize IT around them and those that touch them ... but in Washington, we're still very much regulating the enterprises, so there's a tremendous mismatch."
Brailer stressed that patients should own their healthcare data and that such information should be organized and regulated around each individual person, a point which another former National Coordinator, Farzad Mostashari, echoed.
"We are pushing more and more responsibility on individuals, and you can't have shared risk without shared data," said Mostashari (pictured left), who now serves as CEO of Aledade, a healthcare company that helps primary care physicians form accountable care organizations. "Individuals should be able to get their own information so that other people can help them make the best choices for themselves."
That connection, Mostashari said, will come through making clear that there are HIPAA requirements that covered entities--including insurance companies, hospitals, pharmacies and doctors--must give patients their data. Such data liberation, he said, is a big component of what many innovators are waiting for.
"[The innovators] are like 'yeah, [the data] is there in theory, but in practice, I can't create a service for patients that presumes they have access to the full clinical and administrative claims information to help them make better decisions for themselves,'" Mostashari said. "The ability for patients to view, download and transmit their data to another place in Meaningful Use is a huge challenge for healthcare organizations that are centered around healthcare providers. Healthcare is centered around the healthcare providers; it's not centered around the patient."
Earlier in the event, Brookings Visiting Scholar Peter Basch (pictured right), who serves as medical director of ambulatory EHR and health IT policy at MedStar Health in D.C., said despite the recent announcement by the Centers for Medicare & Medicaid Services that it is accelerating its shift to value-based payment systems over the next three years, he's not concluding that the stage is set for optimization yet.
"While there are many exceedingly talented people ... who have been able to demonstrate success with existing technology, I would suggest that their success additionally reflects their vision, leadership and dogged persistence," Basch said. "Without taking anything away from their accomplishments, I would suggest that the promise of health IT has not been kept and that the return on the substantial public investment has not yet occurred, and won't until the benefits of health IT are available to all Americans."