CIO Q&A: Standards could ease stress of breakneck HIT pace

CIOs around the country have a lot on their plate right now, according to Marc Probst, vice president and CIO of Intermountain Healthcare in Salt Lake City. Probst spoke about one of the biggest issues in health IT, Meaningful Use, at the Health Information Management Systems Society annual meeting in New Orleans, and Clinical Innovation + Technology recently caught up with him to get his take on how the initiative is rolling out.

Q: What lessons have been learned from Stage 1 of Meaningful Use (MU)?

Marc Probst: Not as many as we probably should have. Stage 1 happened incredibly quickly. We weren’t as informed going into Stage 2 as we should be.

Specifically, I think we’ve learned a lot about interoperability. I think we’ve learned a lot about the need for standards—I don’t think we’ve addressed that, but we’ve learned it. We’ve learned that this is an important issue for our country and people are paying attention to MU and the funds that are being provided for it. I don’t think it’s primarily money driven. People saw this as an opportunity to do what they needed to do around digitizing health records.

Q: What are some of the biggest challenges with Stage 2?

MP: The pace of change and all of the other things changing at the same time. ICD-10, Meaningful Use, the omnibus act. The overall healthcare environment of payment, Medicare and all the issues associated with government funding. It’s all happening so quickly.

I do think people are focusing a lot on Meaningful Use, but they are also seeing the challenges these other things bring. It’s a difficult balance. As a CIO, trust me, it’s a very difficult time to get resources. We’re learning that as well. There aren’t as many qualified resources to do health IT as we need.

Q: What kind of leadership can policymakers or professional associations provide that would help in the rollout of all these initiatives?

MP: Standards. If we had standards around the patient identifier, if we had standards around transported data or even data standards, all of this would still be difficult, but much more straightforward. Interfaces would be easier. Security would be easier. We didn’t address those upfront, but I think we’re at least getting around to that discussion. Policymakers could have set standards and that would’ve made it much easier.

[Professional associations] are trying, but I think they’ve tried for 30 years to get standards in place. I personally think it’s the government’s role to step in and solve this problem.

Q: Any thoughts looking ahead at the timeline for Stage 3?

MP: We need to take a breath. We need to not just layer on more functions and features that people need to do, and actually sit back and reflect on what has happened, the good that’s come out it and how we can start getting value that improves care out of those systems.

At the last [ONC Health IT Policy Committee] meeting, that was the conversation around Stage 3. I was pretty proud of Paul Tang [MD, chair of the committee’s Meaningful Use Workgroup] and Farzad [Mostashari, MD, National Coordinator for Health IT] for actually addressing it that way versus, “Okay, let’s come up with a new set of features.”