DOWNLOAD: HITECH Terminology Quick Reference
Make sense of the alphabet soup of acronyms
I and IT Business Edge colleagues Lora Bentley and Loraine Lawson have all written about health care IT this week, specifically the push to get doctors, hospitals and other organizations to adopt electronic health records. Organizations that meet "meaningful use" requirements can qualify to receive federal incentives for medical records systems under the HITECH Act.
But as Lora wrote, many hospitals and other organizations say "meaningful use" requirements are too stringent. She cited a New York Times article in which several medical professionals called the government's expectations unrealistic and said it would be tough for many organizations to implement electronic health records by the government's deadline of 2015.
Sharing data is a clear winner for patients in the long run. The mechanism to do it right now just seems a little draconian.
While the banking and automobile industries were given more latitude as to how they spent stimulus funds, health care providers face very specific requirements. Not only that, he told me, but "meaningful use" dollars won't cover the expense of introducing new technology for many organizations. For organizations with little of the required technology already in place, "meaningful use" money might cover 25 percent of the total cost to introduce electronic health records, estimated De Venuto. Norton is farther down the road than many hospitals because of CareLINK, a common clinical system used by all of its hospitals and freestanding image centers. Explained De Venuto:
It's fairly integrated, so the nurse and the lab and the pharmacy and the radiology department are all looking at the same system. If you've been to any of our hospitals, the doctors at the next hospital you go to in our system can see what happened at the last hospital. Implementing that system was a major undertaking in and of itself, but along the way we also implemented an enterprise-wide PAC (picture archiving and communicant) system so digital images are now also incorporated in the medical records.
The common platform positions Norton to add more advanced clinical features and puts Norton "in sync" with the "meaningful use" requirements, said De Venuto:
We'll accelerate our timeline on a few things if we want to qualify for "meaningful use" dollars, but what it comes down to is, all those things are the right things to do to improve patient care.
Norton's physician practices will present a greater challenge because their processes generally aren't as well documented or as automated as those in the hospitals, De Venuto said.
Loraine wrote a post in which she predicts a coming land run on health care IT, in which technology vendors are eager to help companies spend some of those government dollars. She also links to her two-part interview with Dr. Doug Fridsma, acting director of the Office of Interoperability and Standards in the Office of the National Coordinator for Health Information Technology. The interview is a sobering read, with Fridsma laying out some of the integration and interoperability challenges of moving to electronic health care records.
De Venuto shared a sobering thought with me as well. Though electronic health records should improve the quality of health care, it's not yet clear whether they wil help reduce costs. He said:
There's still a big debate as to whether there's a financial ROI from implementing clinical systems. Intuitively, there's clearly a quality ROI. I tend to use more of a value on investment rather than a return on investment. If I'm looking at bedside barcode reading, I could say you don't give the wrong meds, so you're at a lesser risk for litigation, so my malpractice insurance costs should go down. But that's hard to back into what your true savings will be.
A few months back, Loraine wrote about a Harvard Medical School study of 4,000 U.S. hospitals that found implementing new technology didn't reduce medical costs. The big lesson here: Simply throwing technology at tough problems won't fix them. De Venuto confirmed that as well. He told me:
People are used to saying, "If I buy that technology, it'll fix that problem." Instead of saying "If I buy something, it'll fix it," we need to start looking at it as a tool in the tool belt. It's not the solution in and of itself. People will say, "We implemented it and it didn't work. It was a bad technology." Not necessarily. It may have been a bad implementation.