CSC consultant: Healthcare reform is driving technology growth

Among the top concerns of health IT professionals attending the Healthcare Information and Management Systems Society's (HIMSS) annual conference in Las Vegas last week were data mining and analysis, clinical decision support, the automation of chronic disease management, patient engagement, accountable care organizations and care coordination across communities, according to Tracey Mayberry, a partner with consulting firm CSC.

Meaningful Use also was on the minds of many attendees, especially after the announcement of the Stage 2 proposals, Mayberry told FierceHealthIT. But he doesn't believe that their desire to achieve Meaningful Use is driving the technology-related goals of healthcare organizations.

"I don't think one is exclusive of the other," Mayberry said. "To have meaningful reform, you must have good data and good infrastructure. All of the Meaningful Use criteria are about requisite infrastructure to improve performance."

Meaningful Use Stage 2 places a greatly increased emphasis on interoperability and health information exchange (HIE). But it is the need for better care coordination, not the federal health IT incentives, that is responsible for the growing interest in HIEs, Mayberry said.

"If you're going to coordinate care over more loosely coupled communities, you have to be able to exchange clinical data across non-controlled subsets of providers," he said. "So that's how that gets imbedded in Stage 2, because we need that infrastructure."

But for the foreseeable future, Mayberry pointed out, the amount of data that can be exchanged between non-related healthcare providers will continue to be fairly limited. The reason is that, while pieces of information can be exchanged across interfaces between disparate information systems, the context for that data is usually not as rich as it is when data moves between systems created and implemented by a single vendor, he said. So, at least until community HIEs become ubiquitous, organizations will continue to prefer single-vendor solutions over best of-breed combinations wherever possible, he predicted.

Mayberry said he expected some changes in the Meaningful Use Stage 2 proposals after the end of the 60-day comment period, which begins March 7. "Look at all the changes in Stage 1," he said. "Stage 1 was tweaked much more than people thought it would be. So I'd expect to see continued refinements in it."

Mayberry added that it might be hard for providers to meet the proposed requirement that 10 percent of patients "view, download or transmit" the health information provided to them online. "The provisions that mandate patient participation will be difficult to achieve, because it requires the non-incented third party to do something."

To learn more:
- see the CSC report on Meaningful Use Stage 2 (.pdf)