The 2010 HIMSS (Healthcare Information and Management Systems Society) conference is now underway in Atlanta in what promises to be a signal year in the world of health IT. The reasons seems to be the confluence of a year long public discussion on health care reform and, very important, the provision in the American Recovery and Reinvestment Act (ARRA), also known as the stimulus bill, that rewards physicians for meaningful adoption of a qualified electronic health record (EHR).
The reward can equal as much as $44,000 over 5 years and is creating a frenzy of vendors asserting that their EHR is certified, meanwhile the community at large is breathlessly awaiting to hear what the government regards as “meaningful use”. The final rules on meaningful use are expected later this year. Partially, as a result this, HIMSS found in its annual survey of its leadership:
“… [these] incentives and a rebounding economy, nearly three quarters (72 percent) of respondents said they expect their IT operating budgets to increase, bringing that response back to the levels of two years ago.”
In the meantime, the non-profit organization which certifies EHRs (CCHIT or Certification Commission for Health Information Technology) continues to develop deeper and broader specifications on what it means to be a “certified” EHR.
These are interesting developments for physicians in a few ways. Most obvious is the financial incentive to adopt an EHR in one’s practice. As the table below shows, the financial incentive decreases the longer one waits to adopt.
Perhaps the most compelling reason for adoption of EHR standardization is to make interoperability the norm rather than the exception. Currently, if you have adopted one EHR for your practice, the burden of changing to another system quickly becomes the fear and difficulty of transferring your medical records electronically. Therefore, innovation can often be dampened by the fact that physician consumers are mostly locked into whatever purchase decisions they have made.
EHR certification and thus partial standardization also opens the door to new business opportunities. I had the pleasure to meet with Dr.James O’Connor, the CEO of a startup named MDcohort LLC, which is developing tools that enhance the entry and maintenance of data by physicians into EHRs with the goal of having better data available for research.
This could make it easier to enroll patients into FDA clinical trials while empowering physicians in negotiations with parties potentially interested in the data, such as the pharmaceutical industry. It also enhances data collection by integrating research tools, such as disability indexes in the initial data capture. Dr. O’Connor says the specialty societies are key to understanding the needs of physicians in each specialty.
There is much more to learn in this sprawling conference where the energy is palpable. The role of informatics in healthcare will only continue to increase and become more diverse. Physician entrepreneurs like Dr. O’Connor will hopefully continue to make sure it works for the maximum advantage of physicians and patients.
Above table from Chilmark Research