It is estimated that only about 8% of the nation's 5,000 hospitals and 17% of its 800,000 physicians currently use any form of computerized record-keeping systems that are necessary for compliance with the emerging, government-mandated certifications.

As the Meaningful Use/HITECH incentives are implemented over the next 6 years, how realistic is it to think this will be sufficient to accelerate IT adoption given the magnitude of these existing circumstances? What are the potential impacts to our healthcare IT infrastructures, the security of patient health records and the quality of patient care?

Paper records, and with it the inefficiencies of silos of disconnected information, will eventually be outdated by a broader acceptance of EHR technologies. If not, the financial realities of marketplace competition will ultimately overcome traditional methods and assist the healthcare IT transition.

The best approach to achieving an effective IT transition is to analyze the overall healthcare IT proposition and take the necessary steps to ensure a pragmatic, balanced approach to mainstream IT adoption. There are three key areas to acknowledge: 

First, physician and patient relationships have traditionally relied on paper record keeping. In light of this, some health care providers have been resistant to EMR methods due to the perceived loss of human interaction. The healthcare IT industry ought to strive to maintain the quality of doctor-patient relationships as much as possible when designing the EMR and EHR definitions – this is essential for creating a viable, practical process that meets the needs of all parties involved in the process.

Second, healthcare providers should design and implement workflows that practically reflect how healthcare practitioners interact with the patient data throughout the workflows.  A balance must be maintained between creating workflows that are technically robust, meet the needs of the practitioners and clinicians responsible for the workflows and are optimum for delivering quality patient care.  Workflow usability is critical and its impact on patient care should be the overriding factor in architectural designs and corresponding implementations.

Third, given the reality of the current healthcare IT landscape, the ONC ought to revise some of the deadlines within Meaningful Use and HITECH to ensure that appropriate attention is paid to ensuring the availability of skilled IT technicians and reasonable balance to achieve IT requirements, including data security and patient exchanges.  Currently, it appears that many of the stimulus incentives have been targeted at IT projects that were underway or ready for implementation prior to the HITECH incentives. As most providers are merely beginning the process, there will be significant pressure to obtain the proposed HITECH objectives and incentives by 2016. This pressure creates risks for healthcare providers embracing IT practices, procedures and certifications and patients will be directly impacted by this process.

To ensure that technology and realistic benchmarks predominate, the HITECH certification effort must rationalize workflow with effective care delivery processes. Healthcare IT’s slow adoption progress historically indicates the timeline for HITECH benchmarks and incentives should be lengthened to ensure a positive result. Implementing new technologies in a complex environment is not a small undertaking and the transition throughout the healthcare IT industry will take time. 

Healthcare IT reform will be expensive and will likely take longer than predicted at the outset in 2009. Nonetheless, experts estimate that a fully computerized health record system could save the healthcare industry $200 billion to $300 billion dollars a year. Compared to the $2 trillion a year spent on information management, the $100 billion dollar expense experts say it may cost to implement the IT reform seems like a bargain.

For more insights on pursuing a balanced approach with health IT, read this white paper, a part of The Integration Generation series.

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