Regardless of who wins the presidential election, healthcare IT leaders are setting their sights on key issues they want the federal government to take action on in the next four years.
The first priority: shoring up the nation's public health data infrastructure, a crucial step to help combat the COVID-19 pandemic, according to health IT groups.
"The pandemic has shown that gaps persist in the data that public health authorities receive, such as missing demographic or contact information that can aid in contact tracing efforts or identify hot spots. The government can take steps in January—and even before—to shore up those gaps and prepare the nation’s data infrastructure for an eventual vaccine," said Ben Moscovitch, project director, health information technology at The Pew Charitable Trusts.
The federal government should help fill gaps in COVID-19 lab data to ensure that critical information like phone numbers, zip codes, race, and other data are shared with state public health authorities, he said. Second, the government needs to prepare for the rollout of a COVID-19 vaccine or vaccines. That will require tracking their distribution to ensure that each individual obtains the right dose or doses, Moscovitch said.
COVID-19 has highlighted the need to invest in a robust public health system that supports health equity. “It’s critical that we bolster the secure flow of de-identified health information into public health surveillance systems,” said Wylecia Wiggs Harris, Ph.D., chief executive officer of the American Health Information Management Association.
Here are four other health IT policies and issues to watch:
Improving patient identification is a pressing priority that has become more urgent during the pandemic, health IT leaders say.
"It’s concerning that our country still lacks a national strategy to accurately match patients to their health information 100% of the time. Giving consumers timely electronic access to their health data, while protecting the privacy of that data, should also be a top priority as part of any new health initiative," said Harris.
Better patient identification and matching will also be crucial to effectively track the distribution of a COVID-19 vaccine, Moscovitch said.
"Existing, common sense, research-based solutions—like using standardized data—can help optimize this process," he said, noting that a bipartisan bill currently under consideration in the Senate would make an existing address standardization tool from the U.S. Postal Service available for healthcare to improve patient matching for COVID-19.
"Many of the steps that could support the response to this pandemic could also make the country better prepared for a future one," Moscovitch said.
Making headway on the patient identification issue at the federal level will be tricky, according to Mari Savickis, vice president of federal affairs at the College of Healthcare Information Management Executives.
"For the second year in a row, the House voted to overturn Section 510 of the Labor-HHS appropriations bill which would remove the 20-year-old ban prohibiting HHS work on a standard to uniquely identify and match a patient to their records. The Senate, however, has lagged in interest," she said.
The pandemic has rapidly accelerated the use of telehealth. The Trump administration has made sweeping changes to Medicare telehealth policies during the pandemic, but many of these changes will only last during the public health emergency.
The Centers for Medicare & Medicaid (CMS) issued a proposed rule in August that will also expand the list of telehealth services covered by Medicare.
The status of telehealth reimbursement policy hangs in the balance without any clear pathway for a fifth stimulus package or the overall costs associated with significant changes, Savickis said.
"Beyond costs, there are concerns around program integrity. Conceivably, this could drag on if movement occurs in a piecemeal fashion or in short-term extensions. The public health emergency is up for renewal should the secretary choose to do that again at the end of January," she said.
The virtual care boom has opened up new opportunities for innovation and industry growth, particularly for wearables and in-home devices that make healthcare more accessible to patients, said Baha Zeidan, CEO of cloud-based electronic health record provider Azalea Health.
"It is my hope that funding is made available to underserved populations so that access to these technologies is delivered to those who face the most significant socioeconomic barriers to care," Zeidan said. "Regardless of the number of seats held by any one party, this presidential term will be marked by mandates and regulations designed to address the fractured data and disconnects that plague the healthcare system."
Another issue will be Internet broadband to support the adoption of virtual care.
"There is a lot of support on both sides of the aisle around rural access to care. And frankly, the benefit of better broadband spills over into other areas beyond telehealth to other areas we care about like cyber and interoperability," Savickis said.
The 21st Century Cures Act is bipartisan legislation that spurred the new information blocking policies and regulations pushing for patients to have easier access to health data through smartphone apps.
The Trump administration built aggressively onto what was initiated under the Obama administration around driving further consumer access to their care, according to Savickis.
"I find it unlikely the foot will come off the gas no matter who takes the White House in 2021," she said.
The Health Information and Management Systems Society (HIMSS) issued a statement that its 80,000 members are advocating for the next Congress and administration to leverage health IT to combat the pandemic and ensure greater health equity through investments in public health infrastructure and continued work on standards-based interoperability.
"As we’ve advocated for the past year, investments in public health infrastructure will help address some of the glaring gaps in the emergency preparedness, public health response and we anticipate health IT will be a critical tool to ensure equitable distribution of personal protective equipment, testing, contact tracing, and vaccines," HIMSS said in its statement.
Security and privacy
As evidenced by the sectorwide attack that began last week, cyberthreats against the healthcare industry are only going to grow in complexity and concern.
"Cyber has been a big focus on both sides of the aisle. While cyber is a threat to all critical infrastructure sectors, we think there needs to be more attention on healthcare," Savickis said.
Data privacy, particularly protecting the privacy of health data, is a hot button issue that has drawn interest on Capitol Hill as tech giants move into healthcare.
"There was some interest in privacy around contact tracing apps but this never fully saw lift-off. We expect Congress to take up the conversation again next year and the differences will be philosophical ones that could be drawn along party lines," Savickis said.