When it comes to implementing electronic health record systems and exchanging health information electronically, healthcare providers are being incentivized, nudged, or hit with a stick. As everyone reading this probably already knows, healthcare providers have until 2015 to be deemed "meaningful users" of certified EHRs before they are penalized under the regulations outlined in the HITECH Act.
The big question is will we spend this stimulus money in a way that truly makes healthcare more cost effective and improves the quality of care for patients. Almost every one that I talk to makes a point to say that the HIT Policy committee is approaching this the right way—although they may grumble about recommended guidelines being too aggressive or not aggressive enough.
A lot of questions still remain and the final definition of meaningful use and the certification criteria for vendors likely won't be finalized until the first quarter of 2010. So will the HITECH Act—based on where we are headed and the work that has already been done—achieve its goals? I know. It's a tough question to answer and no one has that crystal ball to glimpse into the future. But if we are getting off track, the time to correct the situation is now or we could end up wasting a lot of tax payer money for naught.
"We have a fragmented healthcare system where patient data is not available, so we want informational integration at least," J. Marc Overhage, MD, PhD, director of medical informatics and research scientist at Regenstrief Institute, Inc. and president and CEO of the Indiana Health Information Exchange, told me during an interview for HealthLeaders magazine's August cover story, "Hang On."
We were discussing whether smaller community and rural providers would be left behind and the impact that would have on the healthcare system as a whole.
"It is important that we move the whole market and not just fragments of the market," said Overhage, adding that "if I can send and receive healthcare data, but no one else is out there to do it—the patients won't get any benefit."
The challenges for rural providers are well documented. Certain regions still have limited or no Internet connectivity, many rural providers are barely scraping by financially and have extremely limited access to capital to purchase EHRs or build the infrastructure required to support the EHR, and most do not have the IT support staff to implement and maintain EHR systems or negotiate with vendors to ensure all of the certification requirements for meaningful use will be covered.