Is Meaningful Run Equally Good Successful?

Approximately a quarter ane chiliad m clinicians too hospitals convey signed upwards for Meaningful Use incentives to date. Of those, almost a hundred chiliad convey received over $5 billion inward incentives. In add-on to the registered providers, at that topographic point are pregnant numbers of practicing physicians who produce non qualify for incentives, due to payor mix or practise characteristics, too who are equally good buying too using EHRs. Perhaps this is a chip slower than the most optimistic projections, simply the entire plan seems to survive forging ahead rather well, too EHR adoption is steadily increasing.

The EHR incentive plan is funded past times taxpayer dollars to the melody of $30 billion, inward the midst of a harsh recession, too is supposed to motivate our wellness help providers to purchase EHRs because according to the White House, the Secretary of Health too Human Services, the Centers for Medicare too Medicaid Services (CMS) too manifestly the Office of the National Coordinator for Health Information Technology (ONC), EHRs are the cornerstone on which the acre volition gear upwards strategies to command wellness help costs patch improving population wellness too lineament of help for individuals. Since wellness help has urgent problems that take away to survive resolved now, wellness help providers are receiving incentives to purchase software now, job it inward prescribed ways now, too the bar is continuously raised until the ultimate goals are achieved. In add-on to straight cash incentives to wellness help providers, both CMS too ONC are funding, through grant making, all sorts of other wellness help invention activities, including novel technologies, novel help delivery models too novel payment arrangements.

One of the ONC initiatives is the Strategic Health information technology Advanced Research Projects (SHARP) plan aimed at evolution of novel wellness information technologies. The SHARP grants, of $15 ane chiliad m each, were awarded over 2 years agone to several universities, amongst the ultimate destination to accelerate wellness information technology adoption. The SHARP grant for “Health Care Application too Network Design” was awarded to Harvard University to “facilitate information central patch ensuring the accuracy, privacy, too security of electronic wellness information”. The grantees chose to focus on developing an iPhone-like SMART platform for assembling EHRs. Not certain how this ties into network blueprint or the accuracy, privacy too security of wellness information, too admittedly I convey oft expressed many reservations regarding the entire iPhone paradigm, both hither too elsewhere, simply this was 2 years ago.

This month’s effect of NEJM contains an article written past times the Harvard SHARP grantees which is essentially a blistering laid on on the EHR products currently on the marketplace put too those who industry too sell them. According to the authors, it is alone a myth “that medicine requires complex, highly specialized information-technology (IT) systems”.  Since both authors are physicians, let’s assume that they are right too medicine is equally unproblematic equally they contend, inward which representative it is rather unclear to me why afterward 2 years too amongst $15 ane chiliad m inward funding, they convey non solved the job inward its entirety.

The response is of course of education based on the vilification of real successful EHR vendors, since the authors “believe that EHR vendors propagate the myth that wellness information technology is qualitatively dissimilar from industrial too consumer products inward companionship to protect their prices too marketplace put percentage too block novel entrants”. Although I don’t believe at that topographic point is a nighttime EHR vendor conspiracy out there, too I don’t believe that wellness help has much inward mutual amongst Twitter, Facebook too iTunes, I produce concord that wellness help information technology is similar to other “industrial” products, similar say, banking, which maintains huge proprietary systems, based on Oracle too IBM software (very expensive) inward private information centers (no Amazon clouds), too equally funny equally it may seem, ane of the largest online brokerage firms is using the same MUMPS database equally ane of our largest EHR vendors, which past times the way, is equally good used past times the European projection that is mapping the Galaxy galaxy. Just because something was get-go invented inward the sixties (like the Internet), it doesn’t hateful it has non changed since, too it doesn’t necessarily hateful that it is instantly obsolete. Anyway, equally it turns out, other industries cannot run multimillion dollar businesses amongst gratuitous iPhone apps either. Bummer.

Speaking of mythology, the article goes on to regurgitate the most mutual myth, asserting without citation that “[c]ommercial EHRs evolved from practice-management (i.e., billing) systems, too inward response to the patient-safety movement, vendors tacked on documentation modules too companionship entry for physicians”. Really? Did Cerner start out equally a billing system? Did Epic? What close the many smaller ambulatory EHRs, similar Amazing Charts, that don’t fifty-fifty convey a practise management module? And how close the shiny novel entrants who appear to non survive equally blocked out equally the authors imply? How close Practice Fusion too athenahealth? No, they are non built on a bits too pieces apps model, simply they are novel too doing rather well, I believe. One amongst no billing at all too the other ironically, precisely evolved from a billing system, too both regarded equally cracking innovations.

The frustration expressed inward this article is pretty mutual fare from folks trying to travel inward the EHR marketplace put alone to break that the simplicity they envisioned from the exterior is cipher to a greater extent than than a mirage. Health information technology is a savage temptress inward that way, too many convey succumbed to her lures of quick riches. However, this item article was written past times people who are funded past times ONC equally business office of a national endeavour to instruct doctors too hospitals to purchase too job EHRs, too this article is titled “Escaping the EHR Trap — The Future of Health IT”. Are the authors contestation that the EHRs that ONC wants people to purchase today are a trap? Should doctors too hospitals halt their Meaningful Use efforts too human face until Harvard, if “properly nurtured” (with to a greater extent than taxpayer dollars, I presume), comes upwards amongst their version of EHR? Does ONC back upwards this position?

On the ONC website, the description of the Harvard SHARP grant opens amongst this sentence: “Today's HIT environs is largely populated past times outdated one-size-fits-most systems”. This is the same website that was role built to encourage wellness help providers to purchase EHRs. Is ONC knowingly paying hospitals too doctors billions of dollars to purchase “outdated” systems? I don’t intend so, simply I produce believe that ONC should come upwards up amongst roughly variety of response to this article, too possibly survive to a greater extent than careful amongst the contents of their website too amongst their grant making processes.