The Obama administration's plan to spend $19 billion to hasten the adoption of electronic health records that can share data across networks will only give more impetus to the shift toward Internet-style computing. One good example of the trend is a joint project, between the Centers for Disease Control and Prevention and GE Healthcare. The project will deliver individually tailored public health alerts to electronic health records in doctors' offices. The goal, for example, is to have an alert pop up on a physician's screen that a certain patient, based on location, age, and perhaps occupation, might be at risk for an influenza outbreak that is nearing a certain community or for contracting a food-borne illness.
General Electric and Intel are joining forces to try to cash in on the trend of delivering more healthcare outside hospitals and doctors' offices. The companies plan to spend $250 million jointly in the next five years on research and development of health technologies to let doctors remotely monitor, diagnose, and consult with patients in their homes or assisted-living residences. Both companies have fledgling offerings in the field of telehealth and home health monitoring.
The Collaborative Communications Summit is scheduled for June 16-17, 2009, in Fort Lauderdale. The summit is designed to help top-level executives, legislators, physicians, regulators and technologists handle health information technology change, policy development, and changing business models, according to the organization's Web site.
With the announcement that the federal government's plans to spend $19 billion to spur the use of computerized patient records, the industry has a renewed interest in how and when hospitals should begin to adopt electronic health records.
But what about hospitals already entrenched in EHR? What's next for them?
Physicians at the Medical Clinic of North Texas have been using an EHR for nearly 10 years, says CIO Mike Yerrid. He will be focusing on expanding into the health information exchange arena, to connect other physicians within the Dallas-Fort Worth region, with the eventual goal of establishing a medical home model.
"We are a large primary care medical group, and there's value to exchanging our electronic information with other groups in the area," says Yerrid. "We're hoping people will join the game. We're trying to sell the benefits and create an attractive package for specialists and primary care groups."
States and counties throughout the country have experienced varying levels of success when it comes to getting HIEs and RHIOs off the ground. Respondents to the HealthLeaders Media Industry Survey 2009 were split fairly evenly on the topic. We asked them, "Which of the following best describes your thoughts about regional data sharing projects, known as RHIOs?" About 37% of CIOs said they expect RHIOs to take hold over the next decade, another 35% said they expect them to fizzle due to lack of funding or management issues, and the remaining 28% said it's too early to be concentrating on RHIOs and the industry should first focus on automation efforts.
Yerrid says he expects the medical group to face interoperability issues. "It will be a challenge. It's one of those situations where if you had the only phone in the world, what value is the phone? And in the past one of the main problems with creating an HIE has been finding a revenue model that works. Our plan is to use the stimulus money to invest in the future, rather than pay ourselves back," he says.
Despite the challenges (interoperability, revenue, funding) that surround launching an HIE, the number of operational health information exchange initiatives increased considerably between 2007 and 2008, according to the eHealth Initiative. eHealth's eHealth's latest survey results indicate 42 operational HIE initiatives, up from the 32 in 2007 (a 31% increase). All 32 operational health information exchange initiatives that responded in 2007 continued to be in operation in 2008.
Yerrid says he expects that number will grow once the stimulus money begins to flow. "I think people are starting to see the real value that can be had from exchanging information this way. The creation of medical homes, by connecting specialists and hospitals, and the rest, is really the way we are going to expand coverage and improve healthcare," he says.
Since many hospitals are hunkering down and putting projects off to ride out the bad economy, Yerrid says now is the time to be performing due diligence to ensure all of the government's available incentives are being maximized. Once things get better, he says, that will be the time to begin to ramp up HIE efforts again.
"From an IT perspective, we don't always have to be running at full throttle, and this is one area where I think we can just tap the breaks a little bit. With that said, we're maximizing our e-prescibing incentives, our PQRI incentives, and working with pay-for-performance objectives to max those revenues so that when things do get better, we'll be ready to move forward quickly," he says.
There have been some small wins when it comes to advancing HIEs. And though 31% growth is incremental and not momentous, it's important to remember that increase came about before the stimulus plan was announced. Once that money starts coming in, more healthcare organizations will follow in the footsteps of Medical Clinic of North Texas.
—Kathryn Mackenzie
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While a national survey recently found that most U.S. hospitals are behind the curve on implementing electronic medical record systems, nearly all facilities in the Sacramento, CA, area have already begun putting such systems in place. However, one hospital system—Sutter Health—has been slow to implement an EHR system, citing the country's current economic troubles.
New reasearch suggests that a five-in-one polypill could guard against heart attacks and strokes for those over 55. Although progress on the research has been slow over the past five years, there is a trial of the pill currently being conducted in India. And it has already shown that the pill has "the desired effects and is safe and well-tolerated by those who take it." There are some medical experts, however, who question the ethics of the pill as it relates to lifestyle issues—they believe such heart-related problems should be tackled with diet and exercise rather than merely "popping a pill."