“Adoption of EHRs among office-based physicians and non-federal acute care hospitals is increasing but not fast enough” said Farzad Mostashari, M.D. National Coordinator for HIT at HHS. Speaking at the September 28th Alliance for Health Reform briefing on Capitol Hill, he sees meaningful use as a building block using technology to gather information, improve access to information, and in the end, transform our healthcare system.
Dr. Mostashari pointed out that the HITECH Act was the framework for Meaningful Use of EHRs. The HITECH Act made it possible to establish regional extension centers, develop workforce training programs, provide Medicare and Medicaid incentives and penalties, state grants for HIEs, a framework for standards and certification, a privacy and security framework, and provides funds for research.
The Dean Health System President and CEO, Craig Samitt, M.D., sees the impact that Health IT and analytics has on the Dean Health System. The Dean Health System is a large integrated delivery system in the Midwest and operates with a team of nearly 500 doctors, 4,000 staff, 60 clinical and retail facilities, a 300,000 member health plan, and a 2 million member pharmacy benefit manager.
As Samitt reports, EHRs have enabled health systems to focus on population health, health information exchanges are reducing waste and improving safety, technology has improved performance, have the ability to profile providers, able to shift incentives from volume-based to value-based, able to measure needed changes, and have improved population health and quality.
A.D. Racine, M.D., PhD, Senior Vice President and CMO of the Montefiore Medical Center (the university hospital for the Albert Einstein College of Medicine in the Bronx) provides care for 1.4 million consisting of a large underserved population with a high demand for care.
Specifically, 30 percent live at or below the poverty line, there is a high burden of chronic disease, there is high utilization of hospital care, and a high proportion of the residents lack health insurance or are part of public insurance programs.
Dr Racine discussed how effectively the “Bronx Ongoing Pediatric Screening in the Medical Home” (BOPS), a collaboration with HRSA and the Albert Einstein College of Medicine is progressing.
The screening program uses a 12 member consortium of pediatrics, family medicine, and school-based practices in the Bronx to design, implement, and evaluate a universal culturally appropriate screening regimen that is used across the pediatric lifespan from birth to adolescence.
BOPS design includes an IT interface to screen newborns, perform developmental and social emotional screening for infants and toddlers, perform mental health screening for school age and adolescents, and provide screening for adolescent sexually transmitted infections.
Christine A Sinsky, M.D., is a general internist at Medical Associates Clinic and Health Plans located in Dubuque, Iowa. In addition, she is a member of IOM’s Committee on Patient Safety and HIT and co-author of IOM’s discussion paper released September 2012, titled “Comparative User Experiences of HIT Products: How User Experiences Would Be Reported and Used.”
As Dr. Sinsky explained, “EHRs have the potential to play an unparalleled role in improving care coordination and healthcare quality. Much of the discussion has focused on physician adoption—as it should, but one key issue has been left out. We don’t just need more physicians with EHRs, we need better EHRs. As the usability of EHRs improves, physicians will flock to the technology and use it meaningfully just as we do with IT in the rest of our lives.”
For more information, go to www.allhealth.org.
