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David Blumenthal: Committed HIT Advocate

 |  By gshaw@healthleadersmedia.com  
   December 02, 2010

"It makes them better at what they do, rather than just reporting what they do."

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is David Blumenthal's story.

David Blumenthal, MD, isn't very well known outside of the healthcare industry.
But among healthcare providers—especially IT leaders—he's kind of a rock star. When he speaks at healthcare conferences (he is a popular keynote choice) attendees line up afterward to have photos taken with him.

If you've ever attended one of Blumenthal's speeches, then you've heard the story of how he ended his long-time love affair with his paper prescription pad and embraced electronic health systems, eventually becoming their biggest champion in 2009, when President Barack Obama appointed him as the national coordinator for health information technology and charged him with building a nationwide health information system and supporting the widespread meaningful use of health information technology.

The story goes like this.

In 2002, as a practicing primary care physician at Boston's Massachusetts General Hospital/Partners HealthCare System and Harvard Medical School, Blumenthal met his first electronic health record.

"It was not a match made in heaven," he admits. But he saw that his younger colleagues liked the EHR. And they expected he would use it, too. So one day he was using the EHR to order a prescription for a sulfur-based medicine for a patient with a urinary tract infection. The patient, it turns out, was allergic to sulfur.

Maybe the pharmacy would have caught the potentially fatal error. Maybe the patient would have said something. But the EHR's red-letter alert meant that Blumenthal didn't have to depend on maybes that day.

When asked what it is about that story that resonates with physicians and healthcare leaders, Blumenthal's response is as carefully phrased as his speeches and has the clipped intonation of the busy physician that he is.  

"I don't know if it's effective," he says. "I tell it because it's true. It at least enables me as a physician to talk to other physicians, other nurses, and to show that, A, I understand what they're going through and, B, I think there's value in going through the effort of learning how to use an electronic health system."

Blumenthal has put an emphasis on input and collaboration—backed by regulation in the form of the HITECH Act and some $20 billion in government incentives for those organizations that become meaningful users of HIT. He works with industry trade groups and state and federal offices. He's enlisted thought leaders, formed committees of experts, and sought input from patient privacy and legal rights advocates. He's called on healthcare leaders to be participants and partners in determining the future of electronic health systems.

"We envision a future where information follows patients," he says. "Unconstrained by competitive rivalry, unconstrained by geographic boundaries, unconstrained by cultural disinclinations to collaborate. We want teams to emerge in local communities that make exchange possible. And we will be using the meaningful use framework and all other levers at our disposal to try to make that possible."

Standards and certification, financing, technology, logistics, privacy and security, software and hardware—there are a whole lot of questions for Blumenthal and his team-mates to answer.

How will competitors share health data without compromising the health of their own organizations? How can organizations afford to gamble their own time and money in electronic systems before the stimulus dollars start to flow? How do small physician practices navigate such a complex path to IT? How do they know if they're choosing the right system? And what, exactly, will "meaningful use" mean in future stages of the effort?

"There's no lack of work to be done," he says. "It is hard."

When it comes down to it, though, the answers to all of these questions don't seem as important as the lesson embedded in Blumenthal's story about the patient with the sulfur allergy—that Blumenthal was a better physician with the record than without it.

"These applications will win physician, nurse, and health professional loyalty to the technology. These are the things that will make them committed advocates," he says. "It makes them better at what they do, rather than just reporting what they do. They will see what so many others have seen: That patients are better for it. There is no stronger professional pull than making a professional better at what he or she can do."

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