Despite recent turbulence in healthcare and the country as a whole, as we come into Thanksgiving there have been many positive developments and events this year. Those positive moments are a collection of both general healthcare industry and personal ones from my perspective. It is important to keep in mind that progress is being made and that there are a number of changes to be thankful for.
The Healthcare Industry
As a whole, the healthcare industry continued to progress toward value-based care and away from fee for service. Progress in this direction meant increased focus on collecting, analyzing and meaningfully applying data from a variety of sources. Terms such as precision medicine, population health, and machine learning all latched onto data as a means of promoting better patient care and outcomes. The central requirement for all of these initiatives is data. As indicated, not just obtaining the data, but being able to take meaning from it and make it actionable. While there is not yet a consensus on what data are important or how to use the data, the mere fact that these issues are on the forefront is important.
Emphasizing the need for data lead to calls to stop information blocking and other impediments to accessing data, such as contract terms from vendors. The government believed information blocking to be a significant issue, with regulators and legislators asking questions. Views within the industry are split as to how real of a problem information blocking really is, but the bottom line is that information must be able to flow freely from one place to another. This concern leads to the another major topic of the year: interoperability. Interoperability was the subject of many discussions and lots of commitments. No clear answer was developed, but the pressure is on. If a solution is not found, the government certainly hinted at action, though it will likely be better if the industry can figure out by itself. Foreshadowing potential government intervention, guidance on vendor contracting, specifically in the electronic medical record context, emphasized that vendors cannot lock down data collected within systems. The data collected and created is healthcare information that must get into the hands of individuals and providers. Denying such access will not be tolerated.
In one of my favorite positives of the year, long desired HIPAA guidance was prepared and distributed with an increasing frequency by the Office for Civil Rights (“OCR”) and the Office for the National Coordinator of Health IT. OCR in particular continually highlighted the need to educate new and experienced players in the healthcare industry as to obligations and requirements under HIPAA. Not understanding basic tenets of the law and regulation is no longer acceptable. OCR’s guidance did not break any new ground, just repeating long understood interpretations and requirements. However, the guidance drew new attention and seemed to appease the desire for information. Any outreach is a good thing, especially when that outreach confirms common beliefs.
One final industry development to commend was the real (and hopefully ongoing) engagement between the Centers for Medicare and Medicaid Services (“CMS”) and physicians. CMS did not start off on the right foot as evidenced by widespread condemnation of the initial proposed rule to implement the Merit-Based Incentive Payment System (“MIPS”) under the Medicare Access and CHIP Reauthorization Act (“MACRA”). The proposed rule was widely viewed as overly ambitious and destined to drive physicians out of business. In response, CMS and its Acting Administrator Andy Slavitt went on a barnstorming tour throughout the country to meet with physicians and other industry players. Thousands of comments were also submitted. After collecting all of this information, CMS issued a final rule for MARCA and MIPS that largely satisfied many in the industry. Establishing a level of trust and appreciation between CMS and the healthcare industry will hopefully bear dividends in the future.
On a personal level, I am very thankful for a number of opportunities and developments this year. A big honor for me was being selected as a Social Media Ambassador for the HIMSS16 Annual Conference. Not only did I attend HIMSS for the first time, an overwhelming experience, but I got to meet so many social media friends face to face for the first time. In person meet-ups are a great way to further develop relationships and really create more meaningful friendships. Such was certainly the case as I was able to talk for extended periods of time with a number of people and then continue those conversations after the conference. The new connections also enabled me to participate more in various activities following HIMSS16.
With regard to associational involvement, I cannot forget to include the American Bar Association Health Law Section. Through the Section, I have made countless friendships, found some mentors and also found an outlet where I can play a role in broader legal discussions surrounding healthcare. Being tied into these national discussions is very interesting and helps me see different currents that are running through the healthcare industry. This ability, in turn, helps me work with my clients and provide the benefit of a broader perspective that may not otherwise be readily available.
I am also thankful to the Answers Media Group for launching Healthcare de Jure with me as the host. The program offers me the continuing opportunity to chat with leaders from the industry, the government and elsewhere about hot topics in healthcare. Each guest brings a new perpsective and focuses on a different angle or issue within healthcare. It is an ongoing learning process for me because I need to dive into a guest’s specialization area and then explore that area during the conversation. As with so many other activities, I thoroughly enjoy learning so many new things. I look forward to more conversations on the program.
Lastly (at least for now), I am thankful for my great family, including the addition of a new baby daughter. My family provides a significant amount of inspiration for many areas of my life and drives me to think about issues in a new light.
I hope everyone has a very Happy Thanksgiving and can take the time to reflect on what there is to be thankful for despite troubling circumstances.