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With a healthily large amount of stimulus money coming its way, the HIT Industry attempts to stimulate EHR adoption by promoting faster data exchange between hospitals

With President Obama's allocation of 19 billion dollars to the HIT (health information technology) industry, the pressure is on the healthcare world to produce an organized blueprint to efficiently use the money given to them. One area that is receiving a lot of attention is the interoperability of Electronic Health Records (EHR).

EHRs promise a dazzling amount of control and efficiency for physicians and patients alike, but to this day the interoperability of electronic health records is largely lacking. It is still very difficult for a patient's record at one hospital to be seamlessly transferred to another hospital or another clinic. To help spur EHR adoption, the ability to quickly transfer EHRs to different health facilities has become more important than ever.

Thus, in order to move forward with EHR technology, more attention is being given to electronic health record interoperability technology, which promises to merge the various EHR systems being used in different hospitals by allowing them to harmoniously communicate with each other and efficiently share patient health information.

The 2009 HIMSS conference, which DailyTech attended, brought together over 70 clinical information systems to participate in an Interoperability Showcase designed to demonstrate how this goal can be accomplished with technology already available. The showcase tour illustrated how patient health information can be efficiently and securely exchanged electronically– from application to application, system to system, and setting to setting between enterprises, regions, and nations.

While the ultimate goal of EHR interoperability is to electronically organize patient records in a way that makes them more quickly and conveniently available regardless of where a patient is, the grand scale of this project poses certain challenges. This first hurdle that the HIT industry will need to jump over is the lack of any true standards for EHRs. Thus, one initiative that has begun to gain steam is Integrating the Healthcare Enterprise (IHE). IHE is an enterprise created by a group of healthcare professionals that has established a set of standards to assist with the efficient coordination of EHR systems. Systems based on IHE standards communicate more effectively with each other, and allows for EHRs to be easily transferred.

The success of IHE's standards lies in the hands of caregivers as they are the only ones who can truly put the standards and required steps for easier data exchange into motion. As Michael Nusbaum, (co-chair of the IHE IT Infrastructure Planning Committee) emphasized at the showcase, the goal of IHE is to "provide better healthcare" but IHE is "driven by the end-users" because it is more about the "care providers and not the technology." Although interoperability is far from being completely established, the technologies showcased at HIMSS will hopefully allow the HIT industry to take the first, crucial steps to achieving this goal.



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Promises, Promises...
By jskirwin on 4/15/2009 11:44:38 AM , Rating: 2
quote:
EHRs promise a dazzling amount of control and efficiency for physicians and patients alike, but to this day the interoperability of electronic health records is largely lacking. It is still very difficult for a patient's record at one hospital to be seamlessly transferred to another hospital or another clinic.


Maybe people need to forget the big picture and focus on the smaller one: building an EHR that conforms to how physicians practice medicine - and is 100% E/M (evaluation and management) compliant.

Check out the following article in Medical Economics:
http://medicaleconomics.modernmedicine.com/memag/M...

quote:
One physician personally reported that "The software forces me to enter clinical information in a preloaded format; when I see a patient three weeks later, I cannot find any individualized details of the previous visit or understand why I did what I did."


As for E/M compliance, failure can cost practices huge sums of money - up to $175,000 per physician.

quote:

The government audit evaluated between 20 and 100 charts per physician, and the percentage of charts failing audit for each physician ranged from 20 to 95 percent...

All of the systems had designs that failed to meet all of Current Procedural Terminology's and Documentation Guidelines for Evaluation and Management Services' published requirements for compliant documentation of medical history, physical examination, medical decision-making, and nature of the presenting problem(s) (which is the E/M system's measure of medical necessity)


Interoperability of patient records is a laudable goal. However I'd rather see a system that was:
1. Easy to use
2. 100% E/M compliant
3. Protected practices from malpractice claims (e.g. avoided templating until laws are changed to allow for EHR use)




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