Although any mention of health care policy was absent from President Donald Trump’s inauguration speech, comments by his pick for Health and Human Services Secretary indicate his administration’s stance on health IT.
"Electronic health records are so important because, from an innovation standpoint, they allow the patient to have their health history with them at all times and be able to allow whatever physician or provider to have access to that,” U.S. Rep. Tom Price, R-Ga., said during his confirmation hearing Wednesday. “We in the federal government have a role in that, but that role ought to be interoperability: to make sure the different systems can talk to each other so it inures to the benefit of the patient.”
The interoperability piece would be good news for Cerner Corp., which has voiced support for the measure in the past, encouraging the exchange of health care information among electronic health record (EHR) systems. It also indicates a continuation of the bipartisan attitudes found in the 21st Century Cures Act, which included provisions for EHR interoperability, security and precision medicine.
“You’ve got a bipartisan consensus here, at least you did last year, when we passed the Cures Bill, which had a number of provisions in it,” Sen. Lamar Alexander, R-Tenn., said at Price’s confirmation hearing
In a recent blog post, Cerner (Nasdaq CERN) maintained its position that electronic health record systems would keep an important role in the industry, despite uncertainty about future policy.
“The integral role health IT plays in transforming health is non-partisan, so while we can expect significant legislative and regulatory activities with ramifications for our solutions, services and the overall delivery of health care in the years ahead, we don’t expect targeted activity to devalue the role of health IT,” Meg Marshall, senior director of public policy for Cerner, wrote in a blog.
The new administration may approach meaningful use tied to using EHRs with a critical eye, based on comments by Price.
The incentives stem from the Health Information Technology for Economic and Clinical Health (HITECH) Act, passed in 2009 as part of the stimulus bill, not the Affordable Care Act.
Meaningful use rolled out in three stages: The first promoted EHR adoption, the second emphasized care coordination, and the third is intended to improve health outcomes when it becomes effective in 2018. However, this final piece has not been popular with hospitals.
"I've had more than one physician tell me that the final rules and regulations related to meaningful use were the final straw for them," Price said. "They quit, and they've got no more gray hair than you or I have. And when that happens we lose incredible intellectual capital in our society."
According to a survey by Healthcare Informatics and Quantia MD, more than 28 percent of practices said they would not be able to catch up to meaningful use stage three requirements by 2018. The most cited complaint was difficulty in meeting patient engagement requirements, with few patients interested in signing up to access their records.
“At Vanderbilt, which was an early adopter of the electronic health records, they said stage one was helpful, stage two they could deal with, and stage three was terrifying,” Alexander added. “I had hoped we could delay stage three.”
In its Nov. 30 “wish list” to Trump, the American Hospital Association requested that the administration cancel stage three meaningful use altogether.
This leaves health care IT companies, including Cerner, watching closely for more indications.
“Through all of this ambiguity about the strategy to repeal and replace the ACA, one thing is certain," Marshall wrote. "The pace at which Washington D.C. moves will only pick up after the inauguration, as the new president and Congress are focused on their top policy priorities."