Blumenthal gets personal, calls for teamwork among health IT pros
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| David Blumenthal, MD, national coordinator for health IT for HHS |
During his address Blumenthal shared his personal experiences concerning the adoption of EMRs and gave an overview of where Office of the National Coordinator for Health IT (ONC) healthcare reform initiatives are and where Blumenthal expects to see them go in a year.
Before taking the job as national coordinator, Blumenthal noted that he was a fan of paper records and enjoyed writing out orders in the hospitals on paper. However, he noticed that in 2002, younger colleagues at Massachusetts General Hospital in Boston began using EMRs more frequently.
“I was not going to be the only one in my physician group of ten not using it,” said Blumenthal. “Slowly and gradually, it became clear to me that [using an EMR] was making me a better doctor.”
One anecdote that Blumenthal mentioned was when discharging a patient with a urinary tract infection using computerized physician order entry (CPOE), a warning with red letters came on the screen and alerted Blumenthal that the patient was allergic to something Blumenthal was about to prescribe. “I don’t know what would’ve happened if I had written that order on paper, but I’m glad we didn’t have to run that experiment,” he said.
Blumenthal said he realized that through small victories spread over a health system: “It’s possible to imagine bending the cost curve while also increasing the quality of care and the health of a patient.”
ONC is focused on health IT's use and its benefits; not it's installation, Blumenthal noted. “We will not be happy if every physician in the U.S. has an EMR if the health of a patient and efficiency do not improve...We are working hard at the initial steps towards getting electronic health systems in place because you have to start somewhere."
The notice of proposed rulemaking (NPRM) for meaningful use, the interim final rule of health IT standards and the proposed rule for certification programs were mentioned as efforts that ONC has issued to set a regulatory foundation. According to Blumenthal, more than 2,000 comments were received concerning the NPRM on meaningful use which are currently being analyzing. The final regulation is expected to be produced by the end of spring, Blumenthal noted.
Virtually none of the comments questioned the ONC’s direction, according to Blumenthal, as the idea of spreading EMRs and using them to make them work for the health of Americans was well accepted. Questions that were made concerned the rate of progress and precise pathway that ONC takes, Blumenthal stated. "That is a very unusual privilege to be working on something where there is so much agreement."
Also mentioned was the allocation of $2 billion in discretionary funds under the HITECH Act to help providers become meaningful users of health IT. One example Blumenthal gave was the regional extension center (REC) program that has funded 60 RECs across the U.S., which are designed to bring health IT to family physicians through “shoulder to shoulder sources of advice.”
Focusing initially on primary care physicians, small practices and critical access hospitals, Blumenthal stated that the ONC believes it’s the role of government to take care of those hospitals who lack resources and might need an extra push to overcome market barriers.
ONC, according to Blumenthal, has additionally funded 56 states and territories to provide leadership in the area of health information exchange (HIE). “We understand different localities will have different solutions for HIE," Blumenthal remarked. "We want exchange, not a single solution."
ONC has designed HIE grants specifically to draw states and territories into a partnership and become leaders in their own political jurisdictions for creating HIE and to create their solutions that make sense for their jurisdictions understanding the goal of meaningful use and that it will require robust information exchange, according to Blumenthal.
Going forward within the next six months to a year, Blumenthal stated that a greater focus will be placed on implementing the regulations that are currently being handed down. Blumenthal also said that 15 out of the 130 applied communities will be awarded as beacon communities in a final grant program to take on health improvement and efficiency goals for a population. That announcement could come “very, very, soon,” according to Blumenthal.
According to Blumenthal, in the end, health IT won’t happen because the federal government is paying for it to be put in place but it will be put in place because it is the right thing to do and leadership will make it happen. "It requires that people accept the vision...and work together to make it happen,” Blumenthal concluded.