Dr. Blumenthal HIMSS Annual Conference Keynote

Uploaded by HHSONC on 24.03.2011

Well, good morning, everyone.
I want to start by thanking Secretary Sebelius
for her incredibly generous introduction.
I could not have asked for a wiser or more supportive boss
than she has been over the last two years.
And I can assure you that she will continue
to guide the HITECH programs, the HIT programs,
of the Department with a firm and steady hand,
as she has all the other diverse and important programs
in the Health area
of the Department of Health and Human Services.
I want to thank, also, Marty Harris and HIMSS
for their warm welcome to me
back to HIMSS for the second time.
ONC is incredibly grateful for the support that HIMSS
has provided to our office and to the HITECH agenda
since its inception, since the beginning of HITECH,
and to the HITECH agenda before there was a HITECH.
It's hard to believe that it's been two years
since HITECH passed, and since I came to Washington.
Much has changed.
When I arrived two years ago,
I was flushed with victory over the passage of the HITECH Act.
Last year, when I came to HIMSS,
I was flushed with naïveté over what was possible.
This year, I'm just flushed.
Nevertheless, there is something truly different,
truly historic and unprecedented,
about this HIMSS meeting and about this time in our history.
For now we can finally say,
"Welcome to the age of meaningful use.
Welcome to an era of enormous possibility,
of enormous opportunity."
Call it persistence of last year's naïveté,
but I believe we now have it in our grasp,
within our collective ability,
to transform our health care system using health information
in a way that would have been inconceivable
just a few years ago.
And I think the key to this -- one key to this --
is meaningful use.
Meaningful use can be a transformative,
multidimensional concept and power
to change our 21st-century health care system forever
and for the better.
And I think that there are three key elements
to the age of meaningful use.
The first, and, of course, the best known,
is an incentive system.
But there's much more.
There's also a national infrastructure,
which has never existed before in this country,
and never existed in any other country, designed to support
the adoption and meaningful use of electronic health records.
And third and perhaps most vital, meaningful use
is a device to bring health information to life
to support the care of patients, the health of populations,
and the ever improving capabilities
of a high-performing health care system.
It is a blueprint for what information we should
be able to summon and how we should be able to use it
to improve the health of patients
and the health of populations.
And I think it is no more or less than the tip of the spear
for the creation of an ever more capable,
information-driven modern health care system.
I'm going to say a word about each of these three elements
of the age of meaningful use -- the incentive system,
the infrastructure,
and then the blueprint
for driving information-based change.
The incentive program, of course, became live
January 3rd.
21,300 providers have now registered their intent
to become meaningful users
under the Medicare and Medicaid programs.
The Medicaid program has paid over $20 million
to 25 providers, including physicians, hospitals,
nurse practitioners, and nurse midwives, in four states.
In other words, meaningful use is no longer a hope or a theory.
It is a working, operating program, a reality.
And starting May 1st, the Medicare program
will be making payments, as well,
payments that I think will electrify and grab the attention
of providers throughout our huge health care system.
The incentive program is not only about paying providers.
It's also about transforming a marketplace.
And one of the most important and rewarding elements
of the incentive program has been the way it seems to be
attracting innovation and entrepreneurship
within the health IT community.
That may, indeed, be its most enduring legacy.
And we are aware that the timetable
for stage 2 of meaningful use will be challenging.
And we're committed to making sure, working with the field,
that the next stage of meaningful use,
like the first stage, will be reasonable and achievable.
The national infrastructure is the second element.
A year ago, the Regional Extension Center program
was an idea.
Now it consists of 62 programs
that have enrolled 47,000 providers
with the intent of helping them to become
meaningful users of electronic health records.
We're enrolling 6,000 providers a week or more.
We're well on our way to reaching our target
of supporting 100,000 providers
to become meaningful users over the next several years.
Recently, we added additional funding
to the Regional Extension Center program,
and we gave them special additional funding
to support the work and the needs
of critical access hospitals.
They have a tall order,
the Regional Extension Center programs.
They're doing complicated, important work.
They have a lot to learn.
But they are learning
and getting better every day at what they do.
No country has ever tried to create an equivalent capability
to support the transformation of a health information system.
A year ago, our training programs were just an idea.
Now they consist of 84 community colleges,
who have enrolled 3,400 trainees,
who will graduate this spring
to provide much-needed health IT professionals
to support the work that you in this audience do,
the work of vendors, of providers of care,
of health information exchanges.
We are well on our way to realizing our vision of training
over 10,000 new health IT professionals annually.
In the area of health information exchange,
at the state level, a year ago,
only a handful of states had
health information technology experts
whose job it was to make sure
that health information exchange and adoption
occurred within their jurisdictions.
Today, every state and territory has a health IT coordinator,
and 35 states have approved implementation plans
for health information exchange.
We are well into developing
a federal/state partnership, which we think is essential
to making health information exchange a reality
throughout the United States.
Health information exchange is a team sport.
It happens locally.
It needs local coaches.
The federal government is far too far away from the local area
to provide that kind of catalytic leadership.
We believe the states are part of that solution
and will be part of an ongoing
federal/state partnership into the future.
Standards and certification criteria.
For the first time in history, this past summer,
Secretary Sebelius adopted a set of standards
and certification criteria to put a common platform
under our diverse electronic health record
and health IT community of products.
Those standards and certification criteria
will evolve; they will improve.
We especially know that they need to be more exacting
in the area of interoperability.
And they will move along with the stages of meaningful use
and along with the market.
But they are a critical beginning.
And ultimately, we must make sure that they are
not only standards for the U.S. market, but that they enable us
to participate in international markets,
where health IT vendors and providers can provide service
and sell their products, as well.
The certification process,
another key element of the infrastructure.
Last September, there were
no ONC-recognized certification bodies.
Today, we have six.
They have certified 415 electronic health records
and modules.
Two-thirds of those are being produced
by companies with fewer than 50 employees,
a sign, I believe, of that
critical element of the incentive program,
the ability to stimulate innovation
and to change the health IT market.
Looking forward on the infrastructure side,
about what is needed in the near future,
ONC will be concentrating on creating
conditions of trust and interoperability
that are essential for health information exchange.
And there are two big needs in that area.
One is to assure the public that privacy and security
is ever present on our minds and can be provided
in the context of health information exchange.
My hope is that the Department will take on comprehensively
the privacy and security needs to assure interoperability
over the next several months.
We have a Tiger Team
of our Health Information Technology Policy Committee,
that will report its conclusions within the next month or two.
And we anxiously await those recommendations.
We also envision a flexible, dynamic, and reliable system
of health information exchange,
one that's locally organized and managed,
but operates within the federal guidelines that are necessary
to assure commonality of language
and commonality of standards.
The federal government will offer a variety of tools
to make it possible for interoperability to work.
We will continue to perfect
the nationwide health information network,
both in the exchange variety and the direct variety.
We will continue to work on VLER
and on the CONNECT project.
These tools will be, as all
interoperability and exchange will be,
the product of continuing public/private partnerships,
with federal leadership and private execution,
and constantly forming and reforming teams of consumers,
vendors, providers of care, governmental representatives,
and the full array of stakeholders
who need to participate in a system
of health information exchange to make it work.
Now, the programs I've talked about up to now --
the incentive program, the infrastructure programs --
are pretty easy to describe.
They're concrete,
they're measurable,
even visualizable.
But I think what's most exciting about the age of meaningful use
is that third element.
If you believe, as I do, that within a relatively short time,
most health information will be stored electronically,
then meaningful use provides us a way
to set expectations and goals --
to set, to create a blueprint
for what information should be available, to whom and when,
for what uses, in support of an improved health care system
and improved health for Americans.
Now, just think about that.
This is a mechanism for us, collectively,
as citizens, professionals, and patients,
to answer the following questions, among others --
What information should every health professional,
at a minimum, have available when they see a patient?
What capabilities should health professionals and institutions
have to manage and use that information?
For example, the ability to exchange it.
The ability to use it to coordinate care.
The ability to subject it to decision support.
What information should be available
to consumers and patients, so they can participate
in the management of their own health care?
What information should professionals and institutions
be able to collect and report to the public, to government,
to their own professionals, to hold them accountable
and to hold themselves accountable
for the quality and efficiency of care that they provide?
When, in the history of medicine, have we aspired
to provide consistent, careful, collective answers
to those kinds of questions?
It's a huge opportunity, and to take advantage of it,
the health IT community will have to rise to the challenge.
The health IT community cannot operate
at the margins of the health care system.
It has to be at the vital center of the health care system.
It has to be a partner and co-developer
of the health care system of the future.
Let me be more specific.
Prior to the meaningful use process,
and even since then, there has been a gap
between what health information technology could do
and what it was actually doing in day-to-day work.
This was true in the area of quality measurement,
in the area of population health measurement and management,
in the area of clinical decision support.
It was also true in the area of interoperability
and the creation of the capability
to avoid duplication of services.
Meaningful use is a way of communicating
fundamental requirements for information and its uses
and of harnessing information to performance improvement.
And that is why the process of defining meaningful use
must stay, as we hope it has been, open, collaborative,
transparent, and inclusive.
But it must also be constantly informed by the goals
that Americans wish to see their health care system meet --
the improvement of individual health,
the improvement of population health,
and the improvement of the efficiency
of our health care system.
HIT must meet the needs and demands
of the users of the information
that only HIT can marshal for their purposes.
So these, I think, are the realities and opportunities
of the meaningful use era.
We are now poised, I think, as a community,
to make unprecedented strides in the welfare of mankind.
This is truly an historic moment.
If we commit ourselves to purposeful innovation --
innovation that meets needs and demands
of the users of that information --
we can make a huge difference for our health care system
and for the future.
It's a time of almost limitless promise.
And it has been my privilege to be present with you
at its inception.
Thank you very much for your attention and support.