Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

5 health care IT tips for President Trump

John Halamka, MD
Tech
February 8, 2017
Share
Tweet
Share

As I’ve listened to the confirmation hearings for cabinet nominees, I’ve realized that no one with health care IT expertise has been identified by the transition team. I continue to ask all my colleagues about any contact they’ve had with anyone advising the new administration. So far, no one has been asked anything by anyone related to health care IT.

At this early time in the administration, it’s important to offer advice as to the priorities ahead for the next few years. What would I recommend to the new administration? Here’s my five-point plan:

1. Focus on enabling infrastructure — instead of asking for “pledges” to share more data (the pledge idea should never be used again for anything), create the enabling components that will make data sharing easier. 21st Century Cures asks the Government Accountability Office (GAO) to research the costs and benefits of a national health care identifier. Let’s create a national health care identifier and be done with it. It’s the simplest and most reliable way to coordinate care across multiple providers and heterogeneous EHRs. Let’s create a national directory of electronic provider addresses that any application can query to make data exchange simpler. Let’s create a unified baseline privacy policy and universal consent for data sharing across all 50 U.S. states. As I’ve said many times, you cannot tell the clinicians to drive unless you build roads first. Suggesting that cars cannot drive because of “transportation blocking” when roads don’t exist is just an excuse for lack of infrastructure. Also, the federal government needs to practice what it preaches. If Department of Defense and Veterans Affairs don’t share with each other or if all federal agencies don’t abide by industry-adopted standards and business practices, then the private sector cannot be criticized.

2. Reduce clinician burden and prescriptive regulations while moving to an outcomes focus. Demanding that my ophthalmologist report smoking cessation and vital sign data is not helpful. Ophthalmologists should be graded based on the visual acuity, field of vision and intraocular pressure of their patients. The outcome we want is healthy people. How you achieve it with technology should be up to each hospital and professional. It’s fine to require some reporting of appropriate quality measures and cost data, but don’t try to dictate the workflow of each provider.

3. Strong leadership of the Office of the National Coordinator for Health Information Technology (ONC) with deep domain expertise is critical to avoid regulatory zeal. I describe the later stages of meaningful use as “lead a physician to water and beat him/her until he/she drinks”. There are only three ways to influence a clinician: Pay them more, improve their quality of practice life or help them avoid public embarrassment (malpractice assertions, poor quality scores, high cost compared to their peers, etc.). If the right tools are created that help with those three items while achieving policy goals, they will be adopted. You cannot regulate a solution to every societal problem, but you can align incentives so that people act appropriately. Centers for Medicare & Medicaid Services (CMS) and ONC need to continue to coordinate their work in close cooperation.

4. Focus on cyber security and risk mitigation while fostering trust for data exchange. The new threats to information security and integrity are state-sponsored cyber terrorism, hacktivism and organized crime. Every CIO I know loses sleep over these threats. Let’s work together to identify emerging threats, implement best practices for mitigating risks and investigate promising new technologies like blockchain.

5. Reward innovation instead of co-opting it. Every major EHR vendor laments the burden caused by regulatory compliance and certification. Customer needs and market competition should drive product advancement, not legislation or regulation. 50 percent of clinicians want to leave the practice of medicine because of the administrative burden. We’ve achieved exactly what we have required by regulation — turning clinicians into expensive data-entry clerks. Now that high levels of technology adoption have been achieved, companies should sell their products based on usability and efficiency, not certification.

I do not see these five recommendations as abandoning the gains of the past. I see them as refining the path forward based on what we’ve learned. The last eight years have achieved remarkable gains, and I do not believe we need to lament the gaps remaining, we just need to focus on the right work.

John Halamka is chief information officer, Beth Israel Deaconess Medical Center, Boston, MA, and blogs at Life as a Healthcare CIO.

Image credit: Shutterstock.com

Prev

Doctors can be heroes or villains

February 8, 2017 Kevin 2
…
Next

We must be committed to putting patients over politics

February 8, 2017 Kevin 2
…

Tagged as: Health IT

Post navigation

< Previous Post
Doctors can be heroes or villains
Next Post >
We must be committed to putting patients over politics

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by John Halamka, MD

  • The future of EHR: Here are 5 predictions

    John Halamka, MD
  • 10 crucial guidelines for health care IT

    John Halamka, MD
  • Where does health care IT hurt? Everywhere.

    John Halamka, MD

Related Posts

  • How social media can help or hurt your health care career

    Health eCareers
  • Turn physicians into powerful health care influencers

    Kevin Pho, MD
  • America leads the world in high tech care and health care costs

    Mark Kelley, MD
  • Why health care replaced physician care

    Michael Weiss, MD
  • Writing tips for physicians from a health care editor

    Debra A. Shute
  • Health care is not a service commodity

    Peter Spence, MD, MBA

More in Tech

  • The silent threat in health care layoffs

    Todd Thorsen, MBA
  • In medicine and law, professions that society relies upon for accuracy

    Muhamad Aly Rifai, MD
  • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

    Harvey Castro, MD, MBA
  • Why fearing AI is really about fearing ourselves

    Bhargav Raman, MD, MBA
  • Health care’s data problem: the real obstacle to AI success

    Jay Anders, MD
  • What ChatGPT’s tone reveals about our cultural values

    Jenny Shields, PhD
  • Most Popular

  • Past Week

    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • Do Jewish students face rising bias in holistic admissions?

      Anonymous | Education
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • Registered dietitians on your care team [PODCAST]

      The Podcast by KevinMD | Podcast
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
    • ER threats aren’t rare anymore—they’re routine

      Patrick Hudson, MD | Physician
    • JFK warned us about physical fitness. Sixty years later, we’re still not listening.

      Alexandre Bourcier, MD | Conditions
    • The silent threat in health care layoffs

      Todd Thorsen, MBA | Tech
    • Why true listening is crucial for future health care professionals [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • Do Jewish students face rising bias in holistic admissions?

      Anonymous | Education
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • Registered dietitians on your care team [PODCAST]

      The Podcast by KevinMD | Podcast
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
    • ER threats aren’t rare anymore—they’re routine

      Patrick Hudson, MD | Physician
    • JFK warned us about physical fitness. Sixty years later, we’re still not listening.

      Alexandre Bourcier, MD | Conditions
    • The silent threat in health care layoffs

      Todd Thorsen, MBA | Tech
    • Why true listening is crucial for future health care professionals [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

5 health care IT tips for President Trump
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...