Suffice to say, when John Glaser speaks, the healthcare industry should listen. Even as Glaser moves from the healthcare provider and policy areas of the industry to the vendor side, he remains a respected authority on healthcare IT.
Payment reform has been acknowledged, as Glaser did in his guest column, as something that must happen in order for EHR adoption to really take off. While the federal government, CMS, is taking the lead in paying for the meaningful use of EHRs, commercial insurers must follow. They are expected to follow, and some have already made EHR adoption a part of their pay-for-performance criteria. We need a critical mass of payers really pushing through their own meaningful use of EHRs in P4P programs and contract negotiations to make significant headway.
Health information exchange has been touted as the real value of electronic patient data in EHRs. Even so, sustainability is an issue, Glaser pointed out. Some HIEs and RHIOs have made it work in their regions or communities. There has to be a reason and value for their existence. That's why private HIEs or hospital-based HIEs are on the rise and becoming successful. There's a reason hospitals want to connect to the local physician offices, and vice versa.
It's frustrating that health IT vendors must still be told this, but if you keep harping on the issue the problem may be fixed. Glaser emphasizes that EHRs must "think like a doctor." Take a page from Apple. A friend showed me her new iPad. It's intuitive with a capital I. EHR applications need to truly fit a physician's workflow. The goals in the development of EHRs should be: How does this technology make my professional life easier? How does it make the care I provide my patients better? Then run with the answers, which should be the guiding principles.
And it's worth repeating Glaser's boss, David Blumenthal, MD, when he was advisor to ONC, that using health IT in the healthcare setting is a business imperative. It is the cost of doing business.
