AMDIS Award-winner on Data Security and MACRA

Medstar Health's Peter Basch, MD, says the March data breach that crippled its systems and sparked an FBI investigation, "helped us as an organization to be more prepared for the next time."

Each year, the Association of Medical Directors of Information Systems (AMDIS) recognizes outstanding achievements in the field of applied medical informatics.

This year's individual winner, announced last week at AMDIS' 25^th Annual Physician-Computer Connection Symposium, is Peter Basch, MD, senior director for IT quality and safety, research and national health IT policy at Medstar Health in Washington D.C.

In an interview, Basch discussed MACRA, EHRs, and life in the data breach era. The transcript below has been lightly edited.

HealthLeaders: With all the changes in medicine and technology, are you optimistic or pessimistic right now? It's a crunch year.

Basch: Part of being a doctor, and I am a practicing doctor, is to bring cautious optimism into everything we do, whether it's for the patient who is fearful, or whether it's with a patient who might have a serious illness.

It is certainly not to deny or sugarcoat the truth. But it is to present a sense of where we can accomplish things—that sense of optimism.

l recently made these comments to the American College of Physicians at their annual meeting:

Let's step back a bit and forget the complexity in the [MACRA] proposed rule, and just say, how many of us internists or family docs or whatever one's specialty really were happy with the volume-based payment system? Who felt that it worked for you and your care for patients?

This [MACRA] is a new approach. If it were implemented exactly as proposed, I think it would be problematic, some things worse than others.

Related: MACRA Comment Period Ends With Burst of Feedback

But is it at least pointing in the direction that would allow for us to have a healthcare system that is more understandable, fair, and transparent for everybody, and result in better care at a lower cost, and a better experience for patients, and then those of us working on the clinician side?

I think yes.

HealthLeaders: Are providers increasingly at the mercy of their EHR and other healthcare IT vendors?

Basch: There's some truth to that in general.

But think about a situation at home I have with not being able to stream videos. I'm at the mercy of one or two Internet service providers, neither of which answers the phone when you call them. We're at the mercy of large organizations that control information flow.

So are EHR vendors in a different position? Physicians rely on them to aggregate functions and present things to us that are tested, certified, and work. I don't know if we're at their mercy. At this point in time, it is hard to switch.

HealthLeaders: You're a physician at Medstar Health. Clearly it had to have pained you and everyone in your organization when the data breach happened earlier this year.

Basch: Any time one is a victim of a cybercrime, it hurts. It makes you feel vulnerable. It is the world we live in now.

As a doctor though, what got me, and I have to say, I was very emotional about this, because I'm thinking, all right, there are people who come up with gimmicks to swindle others' money, but the idea that health systems would be targeted with malware and disruptive stuff, do people know that people's lives are at stake when this happens?

You have to deal with it professionally, and you have to come up with approaches to make sure that you are hopefully one step ahead of the next time, because there will be a next time.

It certainly has helped us as an organization to be more prepared for the next time, and I'm thankful that we're responding so quickly that no patient data was compromised. None.

This is a nuisance now, because I have to go through an extra layer of security to get in, but that makes patients feel better.