Bal­anc­ing act

Tech­nol­ogy must be part of an over­all pa­tient-care plan

Modern Healthcare - - Opinions Commentary -

It has been a year of an­tic­i­pa­tion and ac­tiv­ity for health­care in­for­ma­tion tech­nol­ogy and man­age­ment sys­tems. At this time in 2009, the Amer­i­can Re­cov­ery and Rein­vest­ment Act, also known as the stim­u­lus law, had just been ap­proved two weeks ear­lier, and the year ended with the in­tro­duc­tion on Dec. 30 of the draft reg­u­la­tions for elec­tronic health-record stan­dards and mean­ing­ful use. Then, from Dec. 30, 2009, to Feb. 28, 2010: The CMS re­leased a no­tice of pro­posed rule­mak­ing on mean­ing­ful use that iden­ti­fies the cri­te­ria for be­com­ing a mean­ing­ful user of health IT. Both pro­grams have start dates of Oc­to­ber 2010 for hos­pi­tals and Jan­uary 2011 for el­i­gi­ble provider cat­e­gories.

HHS and the Of­fice of the Na­tional Co­or­di­na­tor for Health In­for­ma­tion Tech­nol­ogy re­leased an in­terim fi­nal rule on the cer­ti­fi­ca­tion cri­te­ria and stan­dards for pub­lic com­ment, which will be used to sup­port mean­ing­ful use for the start of the in­cen­tive pay­ments in 2011.

The ONC was in­tend­ing to release a no­tice of pro­posed rule­mak­ing on an HHS cer­ti­fi­ca­tion process by the end of Fe­bru­ary.

Th­ese mile­stones in the his­tory of health­care IT rep­re­sent more than the next evo­lu­tion of health­care de­liv­ery or dead­lines to meet. Over the next five years, th­ese fi­nal guide­lines will set the pace for na­tion­wide adop­tion of the elec­tronic health record with a timeline in place for hos­pi­tals, physi­cian prac­tices and other health sys­tems to fol­low. The pro­posed rule for mean­ing­ful use also in­cludes five broad health­care goals that of­fer an over­all strat­egy to: Im­prove qual­ity, safety, ef­fi­ciency and re­duce health dis­par­i­ties. En­gage pa­tients and fam­i­lies. Im­prove care co­or­di­na­tion. En­sure ad­e­quate pro­tec­tions for per­sonal health in­for­ma­tion. Im­prove pop­u­la­tion and pub­lic health. Upon closer re­view, the in­dus­try has been work­ing to­ward th­ese over­all ob­jec­tives. No mat­ter how you read, re­view or an­a­lyze them, th­ese goals cap­ture the con­vic­tion of our ef­forts be­cause they put the pa­tient at the fore­front of op­ti­mal care de­liv­ery.

Pa­tients must be, and must re­main, the ben­e­fi­cia­ries of IT in the health­care sys­tem. We know from the win­ners of the HIMSS Davies Award of Ex­cel­lence that hos­pi­tals, physi­cian prac­tices, com­mu­nity health or­ga­ni­za­tions and pub­lic health sys­tems us­ing the EHR spend more time with pa­tients in­stead of search­ing for charts.

As of Jan­uary, HIMSS An­a­lyt­ics iden­ti­fied 39 U.S. hos­pi­tals, out of the more than 5,000 that they track, at Stage 7 on its Elec­tronic Med­i­cal Record Adop­tion Model, or EMRAM; 83 hos­pi­tals are at Stage 6. The EMRAM scale tracks EHR progress at hos­pi­tals and health sys­tems by scor­ing them on their progress in com­plet­ing the eight stages to cre­at­ing a pa­per­less pa­tient record en­vi­ron­ment.

Th­ese health­care or­ga­ni­za­tions op­er­ate with in­ter­op­er­a­ble EHRs, tech­nol­ogy that tran­scends com­part­men­tal­iza­tion of care and, in­stead, in­tro­duces and helps foster col­lab­o­ra­tive and qual­ity pa­tient care. All mem­bers of the care team can, and do, work to­gether via the EHR be­cause pa­tient health in­for­ma­tion is ac­ces­si­ble, ac­cu­rate and avail­able—when­ever and wher­ever it is needed.

Such syn­er­gis­tic pa­tient-care de­mands more than tech­nol­ogy; it re­quires a strate­gic and in­te­grated plan for pa­tient care where health IT and man­age­ment sys­tems are vi­tal com­po­nents. Data can be se­curely shared within, across and out­side of health in­for­ma­tion sys­tems through the func­tion­al­ity of a health in­for­ma­tion ex­change op­er­at­ing with the frame­work of In­te­grat­ing the Health­care En­ter­prise and har­mo­nized stan­dards made pos­si­ble through the work of the Health­care In­for­ma­tion Tech­nol­ogy Stan­dards Panel.

But this dis­cus­sion about qual­ity and con­sis­tent health­care de­liv­ery must al­ways re­turn to its fo­cal point—the peo­ple in­volved. From the clin­i­cians at the point of care to the IT pro­fes­sional de­vel­op­ing or in­stalling the EHR, those who de­liver care and ser­vice must bal­ance this equa­tion for the ben­e­fit of the pa­tient.

All of us in health­care must help main­tain that equi­lib­rium and be equipped with the knowl­edge and in­sight to put the pa­tient first. At HIMSS, we will con­tinue to pro­vide cus­tom­ized pro­gram­ming on stim­u­lus prepa­ra­tion, work­force needs and growth, and over­all guid­ance for ca­reers in health­care.

As the 2010 An­nual HIMSS Con­fer­ence & Ex­hi­bi­tion opens on March 1 in At­lanta, at­ten­dees can learn more about th­ese and other top­ics. H. Stephen Lieber is pres­i­dent and CEO of the Health­care In­for­ma­tion and Man­age­ment Sys­tems So­ci­ety.

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