Meaningful Use

EHRs can help prevent, minimize or mitigate diagnostic errors, according to research published in the New England Journal of Medicine. In their paper - "Can Electronic Clinical Documentation Help Prevent Diagnostic Errors?" - Gordon D. Schiff, MD, and David W. Bates, MD, of Brigham and Women's Hospital and Harvard School of Public Health note that this benefit is a "key selling point" for EHRs.

The chorus is growing and getting louder. A bipartisan group of 27 U.S. senators are calling on CMS to relax some of the requirements to achieve meaningful use and adopt a more manageable implementation process.

As EMRs gain greater adoption, multiple types of fraud resulting from exposure of health data has skyrocketed, according to a report by market research company Javelin Strategy & Research.

Jerry Buchanan, Program Manager and Scrum Master at eMids Technologies, Inc., an IT and BPO consulting company, listed five features that are missing from EHRs in a recent article in Healthcare IT News: Information, not data; comprehensive health history; information tailored for various users; tracking the transition of care; and patient-side management of information. Some of the features he highlights seemed so basic to me, it made me ask: If EHRs are not turning data into actionable information and holding comprehensive health history, what are they doing?

The Commonwealth Fund released a report on the usage of EMRs in Denmark. All primary care physicians (PCPs) use EMRs and 98 percent can manage their patients electronically. Usage went from 15 percent in the early 1990s to more than 90 percent by 2000. The keys to success are a coherent national policy, financial incentives to adopt health IT and technical support for providers, according to the report.

I read a pretty convincing blog from Software Advice, a Web site that provides comparisons of EHRs, on how clinical trial participation could be the tipping point for physicians to implement EHRs. It's not apparent how many physician offices will deploy EHRs as a result of the federal incentives. It's probably safe to say that the numbers could be higher, given the concerns that have been voiced about existing barriers to EHR adoption. One of those concerns is a perceived lack of business case for EHRs. So this topic of clinical trial participation is a promising one, and one that should be discussed widely.

Sutter Health, a Northern California not-for-profit network of community-based healthcare providers, announced it will resume implementation of EHRs throughout its hospitals. Not that the large hospital system is a bellwether for the economic recovery, but given that it stopped its initiative because of the recession, it's easy to come to that conclusion at first blush. The second thought is whether other health systems feel comfortable enough to resume their health IT initiatives.

With some standards being dropped and others being added, the Interim Final Rule (IFR) for EHR standards and certification is not aligned with CCHIT's current certification process. If the Final Rule is largely unchanged from the IFR, CCHIT says the new process could slow down the EHR adoption rate.

In the last two years, the Federal Drug Administration (FDA) has received 260 reports of health IT malfunctions, some of which resulted in 44 reported injuries and six deaths. These numbers are prompting FDA officials to call for a federal framework and oversight to ensure patient safety.

Amidst a still-faltering economy, the bright spot has been healthcare IT, thanks to ARRA and its HITECH Act. Just as there is a lot of hope and energy invested in moving the healthcare industry into the 21st century, there are equal parts of anxiety and pessimism that billions of dollars will be spent without transforming the industry in the form of increased quality and efficiency of healthcare delivery, and reduction of medical errors and cost.