Monday, June 13, 2011

Assessing US National Healthcare IT Efforts

As I travel the world speaking about the Health Information Technology for Economic and Clinical Health (HITECH) Act, I'm often asked to present objective evidence that it is making a difference.

Here's the progress thus far:

1.  The HITECH program has elevated our national consciousness about Electronic Health Records (EHR) and moved the market considerably forward.   Every hospital CEO knows the term Meaningful Use and believes it is an important 2011 goal.   On my plane back from Scotland two weeks ago, the person sitting next to me (a scanning software engineer), asked about the impact on Meaningful Use on the scanning software market.    With every strategic affiliation BIDMC proposes, the first question asked is how Health Information Exchange (HIE) will support care coordination and the analytics which support the evolving payment models of healthcare reform.    It's clear that EHR and HIE have become commonplace topics of conversation.

2.  State HIE plans require a focus on e-prescribing, electronic lab result messaging, and clinical summary exchange.    State will have to report metrics.   With publicly reported metrics, you can be sure states will be motivated to accelerate adoption.

3.  Every recipient of federal HIE funds had to create a strategic and operational plan, which is a great step forward.  Those plans are publicly available.   As Beacon community and HIE success stories become widely known, it's likely these HIE plans will be revised so that a network of networks connecting state HIEs together will evolve.

4.  Kaiser recently podcast an interview with Farzad Mostashari, National Coordinator, highlighting the progress thus far.

5.   According to the National Health Information Technology Research Center (HITRC), the HIT Regional Extension Centers nationwide have enrolled more than 50,000 Priority Primary Care Providers (PPCPs) to begin the process of achieving Meaningful Use.

6.  Doug Fridsma notes that Direct Project for health information exchange has support from vendors which constitute 90% of the US IT market share.

7.  For the first time in history, patients are telling me they will not go to a doctor without an EHR, since they view it as essential for quality, safety, and efficiency.

Yes, we'll need to wait a few more months before concrete numbers on Meaningful Use attestation are available.   However, I believe the cultural transformation, leading to widespread support for EHRs in the US, has already happened as a result of the US national healthcare IT efforts.


Donald Green MD said...

I am unclear what is meant by impact. Could you explain exactly what you mean? Certainly there is a wide gulf between dissemination of rules and regulations and its implementation. Could you clarify further these points?

As far as I understand there is still little movement by small practices towards adopting MU and they represent the backbone of general care in this country(over 50% of the visits).

Further larger groups of care such as Kaiser and Puget Sound have not reduced their costs or shown evidence of better outcomes compared with well run small practices even sans EHRs.

Ed Larkin said...

I recently moved to Phoenix where I rented several storage units to hold our furniture until we purchased our home. I was asked for my thumb print as part of the documentation process. With no unique identifier such as a thumb print, how will we really achieve true meaningful use?