With funding from the American Recovery Reinvestment Act (ARRA), the federal government is poised to distribute over $21 billion in incentive payments to hospitals and providers to spur the use of electronic medical records (EMRs) and health information exchanges (HIEs).
While its primary goal is to improve clinical outcomes and help curb the unsustainable growth of healthcare costs, the program creates an unprecedented opportunity to transform public health initiatives.
However, with the physician and provider communities focused on building EMRs, the public health community’s information needs could get overlooked unless agencies engage early in the process with key stakeholders.
For hospitals and physicians, identifying the best points of entry amidst the massive reform effort can be difficult as the number of unknown variables remain. For example, decisions have yet to be made about how to establish national, state-based and regional HIE systems.
Similar uncertainty exists around what types of organization—large providers, health systems, state Medicaid or community health center networks—would be best to oversee HIE operations. Meanwhile, healthcare providers are focused on assessing how best to implement EMRs, a process that includes reviewing clinicians’ needs, selecting applications, mitigating impact to productivity, and other issues.
While there are many moving parts to the multi-year rollout effort, what is certain is that the anticipated volume of new clinical data to be created through the increased use of EMRs presents a tremendous opportunity for the public health community.
To gather health information currently, agencies typically rely on doctor’s offices and hospital staff to report data manually – a tedious, reactive process that is limited in scope. With access to richer, digital data and the ability to access it automatically, agencies would be given a broader and more accurate sense of disease trends as well as information that could enhance biosurveillance and other public health tracking efforts.
Public health agencies have specific needs. To have an impact on the type of information being collected on EMRs, agencies should consider engaging IT vendors currently implementing software as a service (SaaS) EMRs for providers.
These firms have deployed highly standardized EMR platforms to tens of thousands of clinicians, while providing clinical workflow consultants who tailor EMRs to specific physician practices. Because of their understanding of physicians’ specific interests and needs, clinician experts can ensure expanded public health data collection is added to EMRs in a way that will meet both the doctors’ business needs while also capturing the important health information agencies require.
With a SaaS approach that quickly deploys changes, successful EMR implementations can be replicated to other clinician offices. They also provide a stable environment amidst evolving processes and standards, and can help make a business case for including public health data collections into clinician workflows.
By engaging now in the reform effort in considering a EMR delivery platform, the public health community can achieve greater success in achieving their overall mission. The benefit of the new information can help agencies improve disease surveillance, accelerate detection of events, enhance situational awareness and clarify impact of interventions.
As with any other public health effort, the key is recognizing the opportunity in time to make a difference.
-- Dr. Harry Greenspun is the chief medical officer of Dell Services, Inc.
