Anyone who doubts the complexity of the HIT transition should talk to a lawyer.
That’s our take, at least, based on the news coming out of this week’s AHIMA's 2011 Legal EHR Summit in Chicago.
Exhibit A is how federal policy efforts to support the transition are a veritable alphabet soup of agencies, each with a different area of responsibility. As one attorney speaking at the summit pointed out, ONC “only regulates EHR software, supports EHR adoption and generally tries to sow the seeds of health IT, but CMS oversees the EHR incentive programs for meaningful use while the Office of Civil Rights (OCR) enforces HIPAA privacy.”
Exhibit B revolves around that little issue of how to accurately and securely distinguish one patient’s record from another’s. Speaking to the myriad still-unresolved issues in this area, one speaker “gave an example of a county hospital in Texas with a database of 3.4 million patients. Roughly 250,000 of those patients had the same first and last names, and 70,000 patients shared both names and had the same date of birth. To go a step further: There were 231 Maria Garcias with the same date of birth.”
Finally, Exhibit C concerns a perennial favorite: how the move to EHRs is giving rise to a host of new malpractice concerns. After all, “EHRs make patient information more readily accessible to far more people than any paper chart stashed away in a filing room. They also change how and to what extent medical professionals document patient encounters and add in safety-related features such as clinical decision support.”
Moreover, patients and even attorneys are still not that familiar with the EHR landscape, and, a D.C-based attorney observed, "There is no guide out there to walk people through all that changes with an EHR."
Naturally, policymakers and industry stakeholders are aware of these and many other problems, but many of the solutions remain elusive. And that, when viewed through the HITECH lens, may be the biggest problem of all.
On one level, the HITECH investment is based on the assumption of timely progress as a result of the public’s significant investment in the HIT transition. The longer it takes, however, to solve the myriad problems that providers and policymakers encounter, the greater the chance that support for the public investment may weaken.
