| Computerization of health records vis-a-vis | | | | processes needed to achieve them, and lastly, the |
| electronic health records (EHR) or electronic | | | | specific use of information technology that will |
| medical records (EMRs) is arguably the most | | | | enable the desired outcomes, and our ability to |
| important healthcare information technology (IT) | | | | monitor them." |
| trend these days. Although the healthcare | | | | Of course, technology will play a tremendous role |
| information management arena has been relatively | | | | in the realization of this vision, which is highlighted |
| slow in catching up to technology, physicians and | | | | by the Workgroup's early call for adoption of |
| others in the healthcare industry are starting to | | | | EHRs and computerized physician order entry |
| see the impact that IT has had on other | | | | (CPOE), including time- and cost-saving features |
| industries and are ready to utilize technology as a | | | | such as electronic transmission of permissible |
| tool as well. | | | | prescriptions and incorporation of lab test results |
| As paper begins to disappear, utilizing technological | | | | into EHRs. |
| devices to provide secure, timely and logically | | | | According to an Institute of Medicine report, an |
| organized access to clinical information will become | | | | estimated 100,000 people die each year from |
| more realistic and imperative. Of course, with | | | | medical errors in hospitals. To the extent that |
| President Obama's economic stimulus package | | | | such errors are attributed to faulty software |
| offering monetary incentives for adoption and use | | | | systems, companies should focus on providing |
| of EHRs through the Health Information | | | | EHR software solutions that promote using health |
| Technology for Economic and Clinical Health | | | | IT to improve patient safety reporting and data |
| (HITECH) Act, there is no doubt healthcare IT has | | | | analysis and to prevent such errors by providing |
| received a much-needed boost. | | | | built-in safety management protocols and risk |
| On Feb 17, President Obama signed the 2009 | | | | assessment tools, including early warnings and |
| American Recovery and Reinvestment Act | | | | alerts. |
| (ARRA) into law that qualifies hospitals and | | | | The functionality of the EHR product a company |
| physicians for $17 billion worth of incentive | | | | offers is a key element. At the same time, there |
| payments from Medicare and Medicaid over a | | | | are other factors that are equally significant |
| five-year period. Under ARRA, specifically the | | | | towards the fulfillment of EHR adoption. At the |
| HITECH Act, $40,000 to $60,000 may be | | | | end of the day - no matter how technologically |
| available for each physician proving "meaningful | | | | and functionally advanced a product may be - |
| use" of an EHR. | | | | service and support are critical in the overall |
| "It's an investment that will take the long, overdue | | | | adaptability, transition, implementation and |
| step of computerizing America's medical records | | | | continued success. Sound implementation |
| to reduce the duplication and waste that costs | | | | strategies with emphasis on an "evolutionary" |
| billions of healthcare dollars and medical errors that | | | | versus "revolutionary" approach - keeping in mind |
| cost thousands of lives each year," President | | | | the diverse needs of users, whether small |
| Obama said at the stimulus bill signing on February | | | | practices and clinics or large hospitals and |
| 17. | | | | organizations - will be the cornerstone of |
| While the exact definition of "meaningful use" is | | | | meaningful EHR adoption. Indeed, successful |
| yet to be determined by Health and Human | | | | customer implementation experience proves that |
| Services Secretary Kathleen Sebelius, the | | | | those users who started utilizing EHRs early on |
| legislation outlined three requirements: | | | | not only have had the luxury of implementation |
| - E-Prescription - The EHR must include | | | | time on their side, but also have improved their |
| e-prescribing. | | | | work flows and quality of patient care in a |
| - Electronic Exchange of Health Information - The | | | | progressively "meaningful" manner while benefiting |
| EHR must provide electronic exchange of health | | | | from advances in technology along the way. |
| information. | | | | In addition, the role of information networks will |
| - Report Clinical Quality Measures - The EHR must | | | | be vital in improving communication among |
| allow submission of clinical quality measures. | | | | healthcare organizations. An information and |
| In the words of David Blumenthal, M.D., the | | | | communications infrastructure is critical as many |
| national coordinator for health IT, "This is the | | | | avoidable errors and poor outcomes can be |
| beginning of a conversation that will continue for | | | | attributed to inaccessible data, lack of properly |
| some time," adding "there is a long way to go" | | | | documented information and the inability of |
| before a final definition of "meaningful use" is | | | | agencies to share critical information in a secure |
| achieved. The task of defining "meaningful use" is | | | | and timely manner. Therefore, coordination, |
| assigned to the Meaningful Use Workgroup, which | | | | integration and overall management of clinical |
| presented its initial recommendations to the HIT | | | | information across localities, regions and providers |
| Policy Committee on June 16. The key goals | | | | of care is critical if any healthcare IT initiative is to |
| postulated in the initial recommendations | | | | succeed. |
| vis-à-vis a three-page preamble to the | | | | Computerization of health records is inevitable. |
| report and a well-defined, simple-to-understand | | | | The challenge lies not in its necessity - whether it |
| matrix are: | | | | should be done. Rather, it lies in the approach - |
| - to improve quality, safety and efficiency, and | | | | how it should be done. Many have and will |
| reduce health disparities | | | | continue to raise myriad concerns, whether from |
| - to engage patients and their families | | | | a technology, privacy or security point of view. |
| - to improve care coordination | | | | However, as stated by Dr. Blumenthal, "It is a |
| - to improve population and public health | | | | journey we must take if we are to improve care |
| - to ensure privacy and security protections for | | | | through the use of EHRs." Whether we are for it |
| personal health information | | | | or against it or somewhere in the middle, it cannot |
| The Workgroup has clearly developed the | | | | be denied that the effort towards the realization |
| foundation of an inspiring and comprehensive | | | | of "meaningful use" is a positive step on the road |
| definition that sets the groundwork for a tangible | | | | to EHR adoption and computerization of health |
| and substantial vision of transforming healthcare | | | | records. With initiatives such as those undertaken |
| delivery while highlighting that this is a progressive | | | | by the Office of the National Coordinator (ONC) |
| undertaking focused on results and not merely an | | | | under the auspices of ARRA, physicians and |
| exercise in software implementation. | | | | others in the healthcare industry are starting to |
| The preamble states, "The ultimate vision is one in | | | | see the positive impact that IT has had on other |
| which all patients are fully engaged in their | | | | industries and are more encouraged to utilize |
| healthcare, providers have real-time access to all | | | | technology as a tool themselves. As we progress |
| medical information and tools to help ensure the | | | | towards the ultimate vision, utilizing technological |
| quality and safety of the care provided, while also | | | | advances to provide secure, timely and logically |
| affording improved access and elimination of | | | | organized access to clinical information will become |
| healthcare disparities. This 'North star' must guide | | | | more realistic, imperative and ultimately |
| our key policy objectives, the advanced care | | | | "meaningful. |