More tele­health … beefed-up data se­cu­rity… re­vised mean­ing­ful-use rules

Modern Healthcare - - NEWS - By Joseph Conn

2016 will be a year in which tele­health ser­vice de­liv­ery in­creas­ingly be­comes cen­tral to the health­care in­dus­try.

It’s also likely there will be sig­nif­i­cant changes in the mean­ing­ful-use rules for elec­tronic health records, and a beef­ing up of the long un­der­re­sourced area of health­care data se­cu­rity, ex­perts say.

Tech­nol­ogy watch­ers en­vi­sion rapid ac­cel­er­a­tion in the adop­tion of tele­health ser­vices to ad­dress the needs of pa­tients and providers as health sys­tems in­creas­ingly are paid through value-based mod­els.

“2016 is the time for tele­health,” said Nathaniel Lack­t­man, a part­ner at Fo­ley & Lardner who spe­cial­izes in tele­health. A ma­jor fac­tor, he said, is that providers are tak­ing on more fi­nan­cial risk for man­ag­ing the health of en­rolled pop­u­la­tions. “What a provider can do on the front end is use tele­health to make the pa­tient more likely to in­ter­act with a clin­i­cian,” he said.

More states are al­low­ing physi­cians to pro­vide tele­health ser­vices across state lines through col­lab­o­ra­tive li­cen­sure ar­range­ments. Mean­while, 29 states and the Dis­trict of Columbia have laws re­quir­ing health in­sur­ers to cover tele­health vis­its; sim­i­lar laws are pend­ing in six more states, Lack­t­man said. Some in­sur­ers are mov­ing on their own to cover tele­health ser­vices be­cause they see them as cost-ef­fec­tive.

On mean­ing­ful use, HHS in Oc­to­ber re­leased two rules for the $31.7 bil­lion EHR ini­tia­tive, tweak­ing the fed­eral reg­u­la­tions for the Stage 2 pro­gram, which is un­der­way and es­tab­lish­ing fi­nal rules for Stage 3, sched­uled to start in 2017.

But Stage 3, as pro­posed, so poorly aligns with the new Medi­care physi­cian pay­ment pro­gram Congress ap­proved last spring that the Stage 3 pro­gram will need to be re­vised, said Dr. John Halamka, chief in­for­ma­tion of­fi­cer of Beth Is­rael Dea­coness Med­i­cal Cen­ter in Bos­ton. Ei­ther HHS, which kept the “fi­nal” Stage 3 rules open for pub­lic com­ment, or Congress, which has sev­eral health in­for­ma­tion tech­nol­ogy bills pend­ing, will make the changes.

“I have op­ti­mism that there is go­ing to be a de­lay in Stage 3 or a roll up” of Stage 3 into the new Medi­care pay­ment sys­tem, Halamka said.

The new year also is likely to bring more cy­ber­at­tacks on health­care data and higher spend­ing on cybersecurity. “You can look for­ward to more hack­ing. We’re not even close to slow­ing down,” said Michael McMil­lan, CEO of Cyn­er­gisTek, an Austin, Texas-based data se­cu­rity con­sult­ing firm.

Fear of breach costs and dam­age to rep­u­ta­tion is driv­ing board-level scru­tiny of se­cu­rity poli­cies at many health­care or­ga­ni­za­tions. And with med­i­cal de­vices in­creas­ingly wired into pa­tient data sys­tems, “there is the po­ten­tial (of hack­ers) to im­pact clin­i­cal care,” said Lucy Stri­b­ley, a se­nior vice pres­i­dent at se­cu­rity con­sul­tant Booz Allen Hamil­ton.

Many ex­perts hope 2016 will be a year in which pa­tients gain greater ac­cess to health data and tools to en­able them to play a big­ger role in man­ag­ing their own health. Many health­care or­ga­ni­za­tions are strug­gling with how to in­crease mem­bers’ use of their web­sites’ pa­tient in­for­ma­tion por­tals.

“We (should) get away from in­for­ma­tion tools be­ing the sole purview of doc­tors and hos­pi­tals and give them to the Amer­i­can pub­lic,” said Dr. Wil­liam Bria, ex­ec­u­tive vice pres­i­dent of med­i­cal in­for­mat­ics at the Col­lege of Health­care In­for­ma­tion Man­age­ment Ex­ec­u­tives.

More states are al­low­ing physi­cians to pro­vide tele­health ser­vices across state lines through col­lab­o­ra­tive li­cen­sure ar­range­ments.

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