Info exchange evolves--with a little help

Evidence suggests evolution does not happen at a uniform speed in a predictable way; it happens in fits and starts. So National Coordinator for Health IT David Blumenthal's use of the phrase "natural evolution" last week to describe what's happening with the Nationwide Health Information Network is an interesting choice of words.

After all, there's a fair amount of 'creation' occurring, too--federal mandates and incentives attempting to guide development of secure and meaningful exchange of healthcare information within and across states.   

“The federal government is working to enable a wide range of innovative and complementary approaches that will allow secure and meaningful exchange within and across states, but all of our efforts must be grounded in a common foundation of standards, technical specifications and policies,” Blumenthal stated.

Meanwhile, out in the field, EMRs, which can enable meaningful exchange within healthcare systems, are catching on--slowly. During a Heart Rhythm Society (HRS) presentation last week, David L. Scher, MD, noted that only 20 to 40 percent of physicians in private practice are using EMRs, and only 3-6 percent are using an EMR the way it was intended to be used.

This backs up the findings of Jeffrey Woodside, MD, and Heather Haugen, PhD, who have observed firsthand the pitfalls of "successful" EMR deployments that falter when the lack of physician support becomes apparent. Adoption, rather than implementation, should be the goal, Haugen and Woodside report. And to achieve adoption, physician buy-in is vital at all stages of the project, not just during the initial system selection phase.

"I think the key to physician adoption is to formally involve them in the governance structure of the EMR project," says Woodside. The criteria for meaningful use provide some guidance in terms of useful benchmarks and metrics of adoption, but "sustainable adoption won’t occur just by satisfying MU criteria," Woodside says.

In the healthcare information exchange world, demonstrable benefits must be part of the natural evolution that allows NHIN and other entities to thrive, and enables US healthcare to adapt to a changing environment.

Mary Stevens, editor
mstevens@trimedmedia.com
   

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