While the healthcare industry anxiously waits for the definition of meaningful use—which will be defined by the Centers for Medicare & Medicaid Services in the next few weeks—I wonder whether the grant programs and initiatives that the Office of the National Coordinator for Health Information Technology has developed during these past few months to help support the adoption of electronic health records and the exchange of health information will be successful.
I commend the ONC for moving swiftly on many of these initiatives to get them in place as quickly as possible given the deadlines providers will need to meet to receive stimulus funds or avoid penalties. However, successfully implementing EHRs is a tricky endeavor and each facility has its own unique challenges. So the question I have is whether these programs will be able to meet the needs of such a diverse group of providers.
For instance, this past week the U.S. Department of Health and Human Services announced that it will be providing $235 million through the HITECH Act for the Beacon Community Program, which will offer support to 15 "communities" that are viewed as technology leaders. The idea is to enable these hospital systems, provider groups, and state and local governments to expand and strengthen their health IT systems and be able to share their experience with others in an effort to discern what sorts of health benefits the industry can achieve when it makes concentrated investments in health IT.
The plan is to select communities that represent large and small, urban and rural, prosperous and underserved regions. "But they will have two things in common: they will all be well above-average users of health IT, and they will be fully committed to employing health information exchange within their communities," wrote David Blumenthal, MD, the national coordinator for health information technology on the Health IT Buzz blog. "The core goal of the Beacon Community Program is to advance specific health improvement goals through interoperable health IT and standards-based information exchange within and among providers, hospitals, and populations."
Examples of healthcare organizations that could be viewed as beacons in their use of EHRs are the Veterans Health Administration, Geisinger Health Plan and Clinics, and Kaiser Permanente. These organizations are so unique in alignment and design, however, I question how useful their approach and lessons learned will be for many community hospitals and physicians.
Similarly, HHS announced a couple of weeks ago that it is investing $80 million in ARRA funds for workforce training. The goal of the program is to address the nation's need for highly skilled and trained health IT professionals. Community colleges will get $70 million of the grant money to develop intensive, non-degree training that can be completed in six months or less by people with some background in either healthcare or IT fields. The remaining $10 million will be used to develop educational materials to support those programs. But will these newly trained health IT professionals really have the depth of knowledge to help support the implementation and adoption of EHRs and health information exchanges? How reliant will some providers be on these IT workers? Are we creating a system that will depend on these workers in the long term? That could be a problem considering that many smaller hospitals or individual practitioners don't have the resources to pay for this support in the long run.