Dan Keller's Nursing, Health Policy & Healthcare Technology Blog

June 5, 2014 -- The Affordable Care Act (ACA) has much to say about healthcare information technology (HIT). It has spawned a new vocabulary.

Few would dispute the goals of the ACA: quality improvement, cost reduction, wider inclusion, data sharing, and more. The buzzwords are patient-centered and value-based. The ACA also mandates:

• Reduction of hospital readmissions
• Improved access to critical care
• Community and population health
• Patient education and engagement
• Chronic disease management
• Preventive care
• Payment reform

• Meaningful Use -- incentive payments to healthcare organizations (HCOs) to acquire certified electronic health record (EHR) technology, and to implement it in three stages over a period of years with measurable goals including effective patient data capture and sharing
• Rural healthcare -- through loans and grants for facilities and technology especially telemedicine, ACA addresses some needs of a long-neglected population
• Behavioral health -- community mental health centers, psychiatric hospitals, clinical social workers, and others who treat substance and alcohol abuse, suicide and psychological distress, can benefit from EHRs and HIT
• Strategic planning -- especially coordination of public and private efforts to implement HIT
• Federal and state coordination -- focusing primarily on consistent implementation of privacy and security that at present vary widely among the states
• Clinical decision support (CDS) -- HIT can help clinicians be more effective (though it cannot replace them) through alerts, reminders, guidelines, condition-specific order sets and eventually evidence-based practice (that ACA calls contextually relevant reference information).
• Data sharing (Health Information Exchange, HIE) -- today's data silos -- clinicians, labs, hospitals, pharmacies, health plans, payers and patients -- must have standards, mechanisms and incentives to communicate, and governance to enable and regulate this across geographic and organizational boundaries so that information can safely follow patients to wherever it is needed
• Consumer eHealth -- provide access to data by patients themselves, empowerment to take action and gain control over their health
• Patient safety -- HIT has risks as well as benefits; mitigate them and prevent patient harm
• Long-term and post-acute care -- the care of patients in these settings, especially elders, is often complicated by co-morbidities and multiple caregivers; policy can support development and implementation of HIT to support such care.

Table of Contents