Commentary: Looking beyond MU

By Farzad Mostashari, MD
12:21 PM
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Last year at HIMSS, I predicted that by now, the majority of all healthcare delivered in this country would be done electronically, not on paper. And you’ve done it!  The adoption of electronic health records has risen to 72 percent among office-based physicians, and 85 percent among hospitals.  More significantly, more than 70 percent use tools like computerized provider order entry, which cut medication errors nearly in half.

But transforming healthcare is about more than just adopting and meaningfully using EHRs.  Our progress and collective efforts in the following three areas are no less important: in promoting exchange and interoperability, empowering patients, and redesigning paper-based workflows to be more efficient.

First, a big push is underway to take health information exchange and interoperability from committees to communities. We’ve made great progress—some of the biggest vendors are already exchanging records with each other, and the number and reach of operational health information exchange organizations is growing by the day. Meaningful Use’s Stage 2 requirements will help tremendously by requiring every certified EHR to be able to send and receive key structured and coded data to support patient care, but we also have to strengthen the business case for exchange. The Affordable Care Act’s payment reforms are starting to do this, and we are also thinking hard about what other policy levers we can use to overcome existing economic barriers and accelerate health information exchange across providers. We’ll make some announcements later today in this area.

I am also proud of the strong push that the health IT community is making to empower patients by giving them better access to information and tools to manage their own care. We are only beginning to understand the benefits, but early data suggest a striking possibility for disruptive transformation.  For instance, according to one study, patients with online access to their medication lists discovered on average two errors or omissions each. The community’s response to the Blue Button pledge program is proof of the value we collectively place on patient empowerment: more than 450 organizations have agreed to give patients access to their health data, and more are on the way. But there is so much more ahead to get excited about: In the future, patients can expect to get easier, hassle-free access to their data (thanks to Blue Button Plus and similar efforts), and there is phenomenal room for growth in the market for apps and services that will use this data to help consumers manage their health, their care and health care finances.

And finally, with the advent of new payment models such as Accountable Care Organizations, more providers are taking the time to redesign workflows and care processes when they adopt health IT, rather than simply placing new systems atop existing paper-based workflows. By re-engineering the end-to-end care process around outcomes and optimizing the use of health IT within existing workflows, we can all make healthcare delivery more efficient.

To get where we need to be, providers must ask several questions about constructive change:  How has health IT helped re-imagine and redesign paper-based workflows? Has time been taken to optimize workflows based on a more collaborative environment?  How are patients empowered to participate more effectively in the care process?  Providers have to speak out and share the changes that have real and positive impacts for patients.

Patient empowerment, health information exchange, and workflow redesign are not easy. But meaningful attention to these areas has the potential to compound the benefits we are already realizing from health IT and to truly transform the way we deliver healthcare in the months and years ahead.