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Top ONC official touts agency's role in precision medicine

WASHINGTON, D.C. -- The new HHS policy that will increasingly funnel federal reimbursement dollars for good medical outcomes rather than fee for service is the framework that the Office of the National Coordinator for Health IT's new chief health information officer sees ONC working within in the future.

Michael McCoy, ONC's first chief health information officer, says in this video, recorded at ONC's annual meeting in February, that in addition to helping providers work toward value-based reimbursement, interoperability will help foster better outcomes by enabling more data to be shared and analyzed effectively. Also, interoperability and faster access to better data will undergird the technological infrastructure for precision medicine, McCoy asserts.

With meaningful use reimbursement funds nearly exhausted, McCoy says that the most powerful lever driving interoperability -- which he sees as the most important work remaining in healthcare -- is the prospect of lower costs for providers and consumers.

Like many in the ONC's leadership, McCoy also often speaks of patient-centered health. He says ONC is trying to spur that approach through emphasizing population health and the ability to improve clinical support by disseminating new clinical advances faster across the medical culture.

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Transcript - Top ONC official touts agency's role in precision medicine

What are your goals over the next couple of years at ONC?

Mike McCoy, M.D.: I am on the senior leadership team assisting Dr. Karen DeSalvo, the national coordinator for the office, in support of what Secretary Burrow's overall goals are. We want to make health a priority for the country -- for not only the physicians delivering care, the clinicians delivering care and the hospital system, but the country as a whole; doing things in a smarter way that promotes better outcomes.

My focus is specifically on interoperability pieces to help make that happen. That is a linchpin to a number of the initiatives under way, not only for the federal health partners, but for the precision medicine initiative that the president announced last week. All of those require interoperable health in support of a person-centric approach to medicine as well as the ability to share data appropriately and securely.

What are the incentives for interoperability in the future, let's say, once the federal money for meaningful use is exhausted?

McCoy: There are a number of potential policy levers that can be applied as we transition to a new model of care. The incentives for businesses, for hospitals, for providers, all have to do with the ability to effectively share data. It lowers the cost of business for those people who can share data, and it lowers the cost of healthcare for patients and businesses that have employees seeking care. All those are important aspects in achieving more effective use of healthcare dollars. Health information technology is a tool in that arsenal of trying to [approach things like] public policy levers, regulatory and incentives which are all different approaches that HHS and ONC will be evaluating to help encourage the adoption of health IT and that interoperability piece.

How does interoperability -- the road map -- address the clinical elements of health IT, specifically community services, population and health?

McCoy: As part of the road map, and one of the infographs that are contained therein, you see that things do start as a person-centered or patient-centered approach, wherein the interactions between the patient and the providers, there is information that flows. That then populates up to not only the panel of health that one might be looking at for taking care of that group of patients that the physician has, it goes up to population health. And it goes even then further to the large group research capabilities and improving the knowledge that we have -- the cohorts of patients that may have a similar disease or condition.

All of those feed into the knowledge and research that allow us to then make better clinical judgments, pass that back down to the practicing physician or the population, and then back down to the patient so that they can be engaged with the precise medicine that impacts their care. Again, considering what their personal wishes and desires are for how that care is approached and delivered.

Is better decision support one of the improvements that will be brought about through real interoperability? And how will that work?

McCoy: Absolutely. It's imperative to have not only the right kind of decisions made for the patient, but that given, [it typically takes]17 years from the time a new discovery is made, or a recommendation is made, before it gets widely disseminated and used by clinicians. There is an opportunity to present at the appropriate time and place, [and to present] that clinical decision support that enables the right care to be delivered to the patient at that right time. Improving the time limits of discoveries and the timeliness of action on that is absolutely a fundamental improvement that we can reach sooner rather than later.  

Can you describe the importance of health IT in the development of precision medicine? What will ONC's role be in helping advance precision medicine?

McCoy: ONC has been specifically identified as part of the budget proposed by the president in continuing to coordinate care for interoperability. Interoperability is critical to achieving the actual benefits of precision medicine so that people can understand, know and be engaged both from a person/patient level, provider level, and all the way up to the research. In order to have that data flow appropriately, health information technology is a fundamental, again, linchpin of that plan and process and ONC is intimately involved in that.

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