ONC offers 4 ways to build better EHR comparison shopping tools
The Office of the National Coordinator for Health IT put forth its suggestions for helping hospitals, physicians and other care providers make more informed decisions about the technologies they buy in a report to Congress this week.
"As the variety of health IT products increases, health IT comparison tools will become increasingly critical to the provider community in the near future," said ONC in its "Report on the Feasibility of Mechanisms to Assist Providers in Comparing and Selecting Certified EHR Technology Products."
In its testimony on Capitol Hill, ONC points out that many similar ratings tools already exist – a dozen and a half of them, in fact, many of them commercial products or developed by professional medical societies for their members' use.
Rather than developing another, the agency suggested that its strength is the data it has accrued, which could be furnished to the private sector to help providers make better decisions.
ONC spotlighted four mechanisms that could help improve the ability to compare and select certified health IT. Two of them focus on providers looking to make smarter choices about certified health IT; two target comparison tool developers themselves, aiming to help them develop better systems.
The first is to give ongoing technical assistance to broad spectrum of the healthcare community – specialists, rural providers, behavioral health and long-term/post-acute providers and more.
Choosing tools that make the most sense for a given provider's "unique clinical needs" demands a certain technical expertise, as well as an understanding of the needed functionality for federal and state quality improvement and value-based payment programs, said ONC. "Although a number of existing comparison tools present comparative information for providers with different knowledge sets, segments of the healthcare community may be unaware of these resources."
Following from that, the second suggestion is a clearinghouse of comparison tool products that can be shared with the healthcare community to improve awareness of what's available.
"Comparison tools exist that may range in cost from free to several thousand dollars for access," ONC noted. "Identifying the comparison tool that best addresses the provider’s needs may be particularly challenging to providers in under-resourced and small practices."
One mechanism to help fix that could be a website that compiles data on all of them: "A clearinghouse of comparison tools could be developed and shared widely with the healthcare community," identifying tools' scope, intended audience, relevant business practices and cost, according to the report.
ONC's third strategy is to making data more publicly available to enable improvements in the comparison tools themselves.
Detailed data obtained by ONC through its certification activities will become available with the release of an updated version of its Certified Health IT Product List this spring. The new "open-data" CHPL will provide more information consistent with the new reporting requirements for health IT certified under the ONC Health IT Certification Program.
"Subjective product reviews and rankings of certified health IT should continue to be the purview of the private sector and professional societies that best understand the needs of their constituents," ONC said.
The fourth suggestion points to the need for better collaboration among the government, comparison site developers and other healthcare industry stakeholders: "In its role as a coordinator, ONC could work with the healthcare community to solicit feedback on comparison tool needs and share best practices with the comparison tool community," according to the report.
"Health IT selection is challenging and the impact of making a wrong decision is costly and time-consuming," said ONC. "While the certified health IT comparison tool marketplace is robust and diverse, there are still significant gaps in not only the marketplace itself, but also in the ability of providers to use the tools to make informed decisions.
"Improving comparison tools’ functionality and utility is only one component in ensuring providers have health IT that supports safe, efficient, and effective care," it added. "Improving providers’ ability to compare and select certified health IT, will require multiple mechanisms that rely on support from both the federal government and private sector."
The overarching question is what role the government should have in developing those tools. This past fall, for instance, Senators Bill Cassidy, MD, R-Louisiana, and Sheldon Whitehouse, D-Rhode Island, introduced the Transparent Ratings on Usability and Security to Transform Information Technology, or TRUST IT Act, which calls for a Health IT Rating Program assess and score technology in its interoperability, usability, security and more.
The legislation calls for the program to be overseen by a so-called development council, convening members of accredited certifying groups, testing labs and ONC. It would grade systems on a three-star scale, helping healthcare organizations better compare and contrast prospective purchases.