Allison Bell. Image: Chris Nicholls/ALM
The Centers for Medicare and Medicaid Services is now trying to make good on efforts by a past CMS administrator, Seema Verma, to make patient data flow freely through electronic health record systems and to and from doctors, hospitals, health insurers, employer-sponsored health plans, patients, and all manner of information providers, analytical firms and app makers.
Verma saw the need for health record data standards and health data networks that work together firsthand, early in her term as the CMS administrator, when her own husband's heart stopped and she had trouble getting his doctors the information they needed to treat him.
Now. Dr. Mehmet Oz, the new CMS administrator, has launched a "Make Health Tech Great Again" effort.
The core of the effort is an "interoperability framework" that's supposed to set the standards needed to make health care data systems work together and open up to one another, to help patients get their records into the hands of providers, connect patients with the tools they need to shop for better and cheaper care, and ease operations for all health care sector players.
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One challenge is memories of the Equifax hack. And the Change Healthcare hack. And the recent news that unidentified bad actors have used Americans' personal information to create 103,000 fake Medicare.gov accounts.
Any new data standards that make life easier for patients and health tech firms could also make attacking health care data networks more convenient for unidentified bad actors.
Another challenge is that setting, implementing and enforcing standards is difficult, and many early U.S. efforts to set broad health data standards have failed.
Employers are where? For employers, another concern may be that CMS is leading the new health data standards push without obvious involvement from the U.S. Labor Department's Employee Benefits Security Administration — the federal agency in charge of overseeing employers' benefit plans — or from employer groups.
At press time, a list of health payers that had agreed to help included five payers: Aetna, Elevance, Humana, UnitedHealth and Medicare.
But not the American Benefits Council, the ERISA Industry Council or other employer groups, and not Cigna, the big carrier that seems to have the most interest in employer plans.
What it means: For employers, failing to have many seats in the room where unleashing The Mighty EHR System might happen, if things work out, matters because any tired, confused patient who uses a health system with an EHR system like MyChart can see the future: The EHR system is the true manager of a patient's care.
If the EHR system makes seeing a provider or a particular type of care easy, the patient may get that care.
If the EHR system requires the patient to find a print button or a download button, and transfer records from one place to another manually, the patient is unlikely to get the care that requires a hunt for the print button or the download button.
The administrators of employers' self-insured health plans now have growing clout in the health care market because they help the most generous payers, the employers, make their payments.
Soon, if current trends continue, the EHR systems and their digital siblings and cousins will be the administrators of the administrators. They will be the health care sector Star Wars universe force that binds the health care galaxy together.
For employers, missing out on a chance to shape U.S. health care data standards governing the EHR systems would be roughly comparable to people missing out on an early chance to shape how gravity works, or how magnetism makes magnets stick together.
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