All these upgrades are necessary for providers to even begin practically preparing their Stage 2 attestations. And only recently have I begun to understand how rudimentary the Stage 2 requirements are, and how even once those attestations are in hand, providers will have some distance left to go to get to cost-lowering, care-enhancing coordination of care.
Disruption as Close as Your Pocket
And yet, again and again, I hear that technology is not the key. Governance is. Even in an age when there are incentives for providers to share information and thus put the patient back at the center of healthcare, it is undeniable that information is still power. Yet too many payers and providers are still nervous about sharing that information, for fear they will lose patients, customers, volume, and market share.
I also continue to hear fundamental questions about the electronic health record model defined by the Office of the National Coordinator, source of $19 billion already spent. Disruption is coming to the EHR model we know and occasionally love. For instance, a company called Docbook MD is offering a mobile phone app that lets doctors share patient information with full HIPAA security by taking pictures of records with their smartphones and emailing them to each other.
Now, if you're carrying around a phone that's three or four years old, that might sound goofy. But having just recently gotten an iPhone 5C and seeing the incredible photos its camera can take, this app sounds quite plausible for acting like a document scanner you are always carrying. It could even transmit detailed X-rays from doctor to doctor.
Compared to the byzantine way Meaningful Use defines the protocols, standards, and services required to share a simple medical record, this sounds like a much simpler way to go, and one that didn't require $19 billion.
Yet, because providers are enrolled in the Meaningful Use incentive program, and because shared cell phone photos alone can't fix healthcare, providers are on a conveyor belt headed into fulfilling the requirements for Stage 2, Stage 3, and beyond, or face penalties. I don't doubt that some of those requirements will fit the need to coordinate care. But I also know that the devil, as always, is in the details.