Sunday, November 21, 2010

National Coordinator at AMIA

Returning from a recent trip to Europe, David Blumenthal, M.D., National Coordinator for HIT stressed the need for consensus building and for collaborative efforts to bring health IT to where it needs to be in the future. Speaking at AMIA’s Annual Symposium on Biomedical and Health Informatics, on November 15th at the Washington Hilton, he is looking towards AMIA to continue the progress in order to achieve the ultimate healthcare vision.

Dr. Blumenthal’s recent trip enforced the need for change to bring the healthcare world into the 21st century. He was able to visit a number of general practitioners in London and found that although the majority of providers use EHRs, the technology is unsophisticated. However, even the basic EHRs are helping to effectively meet healthcare goals, provide quality, and produce good outcomes.

As Dr. Blumenthal stated, there are still four major barriers in place that affect achieving the long term vision for health technology:

• Financial issues due to the cost to adopt and to use and lack of financial incentives to improve performance in order to use all of the capabilities

• Logistical and psychological problems that hamper the changes that doctors have to make to adjust to using technology especially in solo or small practices

• Lack of infrastructure and the lack of a strong business case to develop the technology needed

• Public trust in the program still needs to be established

Dr. Blumenthal discussed the ongoing work on the “meaningful use” initiative which has produced incentives, goals, and objectives. The “meaningful use” program is going to require still more work especially on stage two and three. The initiative has been instrumental in stimulating companies to enter the health IT marketplace.

Several programs have been established such as the Regional Extension Program (REC) to help doctors and the healthcare professionals become “meaningful users”. The plan is for the RECs to help remove psychological barriers, and provide technical assistance as needed. Training programs are in place to staff the RECs.

The ongoing Certification Program is in place to establish consumer confidence when buying equipment and using electronic records. Currently, there are three certification bodies but some are very busy so Dr. Blumenthal wants to establish more certification bodies to be able to maintain a competitive market. Right now the certification process is temporary but will soon become permanent.

Dr. Blumenthal notes that one of the major issues involves exchanging health information. Many countries around the world manage the adoption process for EHRs especially in primary care, but are not yet exchanging information since standards are lacking. Currently, a great deal of hard work is taking place to adopt NHIN but realistically not all providers will participate. But with NHIN, every adopter will have at least one means of exchange.

Right now, the states are progressing towards the exchange of health information and are in the process of team building and planning at the local level. The progress in the states varies in their success level since not all states are the same and some have enormous differences in their state populations that require different solutions.

Dr. Blumenthal discussed how a grant program resulting from stimulus funding is helping states to proceed. One is the Beacon Community Program, in place to enable communities to build and strengthen their health IT infrastructure to improve healthcare outcomes specific to their goals.

Research is very important and the SHARP program is another grant program in place to fund research to solve problems that impede the adoption of EHRs. For example, Dr. Blumenthal talked about research in place at the Mayo Clinic that is examining at different technology approaches, Harvard, researchers are studying how an iPhone web app could be used to gather data, and at the University of Texas, a usability testing laboratory is using a process to measure how well individuals can use a product. Now vendors are approaching the laboratory to get their products evaluated.

Safety issues are very vital to address when using health technology and this issue is now in the spotlight, AMIA has published a report on the topic and that should help to make a positive contribution to help protect consumers. According to the National Coordinator, the EHR system makes healthcare safe but not perfect.

For more information on the Symposium, go to