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Blumenthal: EHRs will become 'an absolute requisite' for docs

February 05, 2010 | Diana Manos, Senior Editor

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WASHINGTON – It may seem unlikely today, but within the next 10 years there will be widespread use of electronic health records across the country, the nation's health IT chief predicted Thursday.

David Blumenthal, MD, the national coordinator for health information technology spoke at the 18th National HIPAA Summit  in Washington DC, where other federal officials and stakeholders said the adoption of healthcare IT is urgent.

"History has shown that things that improve healthcare become part of what is used," Blumenthal said. "I propose to you that in a few years doctors will all support EHRs," he said. "Using EHRs will become a core competency for physicians. And once we've established that, it will be considered an absolute requisite."

Blumenthal compared the kick-off of federal incentives for meaningful use of electronic health records in 2011 to boarding an escalator. "I think we're going to see the upward slope of the adoption curve within a year or two; but it will be difficult to predict the slope," he said.

Carolyn Clancy, MD, director of the Agency for Healthcare Research and Quality, said the usefulness of health data will naturally drive healthcare IT adoption.

"Information is the lifeblood of medicine," she said. "Clinicians are trained to look at patients one at a time. But, what's missing is aggregated information."

Andy Slavitt, CEO of Ingenix said, "One of the saddest parts of our jobs is that no one is asking the questions they once wondered about, but thought there were no answers to. Answers are available, they just aren't getting to doctors. "

Steven Stack, an emergency physician and a member of the American Medical Association's board of trustees said the use of HIT could be both a blessing and a curse. "Doctors don't know how much they don't know. They have no idea they practice differently than other practices."

On the other hand, rules that would determine how a physician must practice should leave room to allow for varying circumstances, especially in the ER, where duplicative tests are most often the norm due to urgency and limited access to patients' medical history.

"There's a lot going on in the trenches that is the only thing that keeps this flawed healthcare system going day in and day out," he said.

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Reader Comments (4)Login to Post a Comment

CP says: Immature Technology
March 09, 2010 | 1:49PM GMT

Re the comments about the immature technology: When we look back at the first release of Windows (to follow the analogy), it definitely does look primitive by today's standards. However, during its time it definitely made computers much more accessible than the arcane DOS system predecessor.

We can see in our current operating systems, however, an unbroken line of DNA back to the original Windows. If Windows 7 is a better product, it is so because it stands on the shoulders of its ever-evolving forebears.

EMR will be the same way. We are in Release 1 at this time. The systems will evolve and improve over time; soon the current versions will look quaint and archaic, similar to the early Windows OS. However, we can use these systems, and they will assist us in bringing about their own evolution. The perfect should not be allowed to be the enemy of the good. EMR must be allowed to take its place in medicine, even in its currently imperfect state.

KBull says: EHR
February 14, 2010 | 9:40PM GMT

Consider the increasing cost of medical care; EHR is obviously another expense to be paid for (By whom?)
Fortunatly, I am essentially retired and therfore will escape this scourge.
If all of a patient's records are filed electronically, will they be edited for brevity or must the MD spend minutes, hours or days reviewing those of a new patient?
How will new information be entered by the MD? A long, typed narrative or perhaps a checkoff list. Such as the five month old infant whose checkoff list included a positive check for 'oriented to time, place, and thing'. Checkoff will be rapid but not reliable, as it does not require a brain to be engaged.
What if the MD misses an important item while perusing several years (decades?) of data and subsequently has an unsatisfactory treatment result? Be assured that the opposing attorney will examine the same record word by word and do so several times.
Let's just list all lab and radiographic results in a central file and skip the rest. Those results may actullly be useful. GOOD LUCK Y'ALL

paulroemer says: EHR--there is no need to rush
February 05, 2010 | 2:59PM GMT

"The time has come," the Walrus said, "To talk of many things: Of shoes and ships and sealing-wax, of cabbages and kings-- ...

The time has also come to ask the question, “Why the rush?” Is the pronouncement that within the next ten years we will see widespread adoption of EHR in conflict with the timing of the Meaningful Use incentives? It seems that way to me.

Whereas we may see an “upward slope in the adoption curve” within the next year or two as hospitals begin the process of selecting and implementing an EHR, we will not see so much as a hiccup in the slope of the Meaningful Use curve.

Why? I think there are several explanations.

• Not enough providers are far enough along to even attempt to pass a Meaningful Use audit.
o Will they complete the requirements
o If yes, will they pass the audit

• Of those who have attempted to do the heavy lifting of EHR and CPOE, they do not know the Stage 2 & 3 requirements. Those requirements may be enough to ensure nobody passes the audit.
• To those providers just underway, whose board insists that they complete the installation in time to qualify for the incentives—good luck. Many will make poor selection decisions which they will support with even worse implementations.
• To those who have yet to start, there is no chance they will meet the target dates.

So what’s next? What would you do if you were having a party and learned nobody could come that night? You’d change the date. Washington will do the same.

What does that mean if you are a provider? I think it means you have enough time to do it right, even when the conventional wisdom is pushing you to hurry.

pgflrob says: Immature technology
February 05, 2010 | 12:41PM GMT

Forcing Doctors to use the current crop of EMR/EHR technology is like forcing people to use Windows Vista, or worse, Window 1.0. The cold dark secret is that the current crop of EMR technology is totally immature. All of the current products will be obsolete before they are deployed en mass - hopefully. EMR/EHR technology needs serious innovation and R&D. The two gaps are in user interface and interoperability. Asking busy primary care doctors to navigate browser based apps with computer mouses and data entry through the keyboard is archaic. The holy grail of interoperability is still a pipe dream.

If this stuff was so good there would not have to be carrots and sticks from the government.