Computerization of Health Records: A “Meaningful Use” Perspective

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

Integrail

Computerization of Health Records: A “Meaningful Use” Perspective