After a hiatus, it’s nice to be back in the rotation in the Healthcare Talent Transformation blogging fold. Thank you, Jonena.
In scanning the headlines to find the latest news and reports on health IT, it is clear that while health IT uptake is moving along nicely since I last blogged here almost two years ago (!), actual health IT *integration* is slogging along.
On the plus side of the ledger, the feds have doled out millions in Meaningful Use incentives to Medicare and Medicaid doctors who bought patient record software and met some abbreviated version of compliance with Meaningful Use criteria. On the minus side of the ledger, the Meaningful Use criteria had to be abbreviated so providers could qualify for the incentives.
Just why is that? Two answers leap to mind. Either a.) the Meaningful Use criteria are too stringent to be met in the timeframe required or b.) providers and software are not prepared to meet them. My money is on a and b. An outtake from an article on Meaningful Use Stage 2 in the December 27th edition of InformationWeek Healthcare explains:
Nearly half -- 47% -- of hospital and health system leaders are "somewhat confident" of their ability to meet the Meaningful Use Stage 2 requirements, according to a new KPMG survey. The respondents included 140 healthcare executives who completed a webcast poll.
In addition, 36% of the survey respondents said they were "confident," 4% said they weren't confident at all, and 11% didn't know what their level of readiness was to meet the criteria, which are part of the government's electronic health records (EHR) incentive program.
When asked to identify the biggest challenge in complying with the standards, the largest group of respondents (29%) cited training and change management...
… Jerry Howell, a principalin KPMG's healthcare consulting practice, in an interview with InformationWeek Healthcare…said he and his colleagues weren't surprised that so many respondents saw training and change management -- rather than technical aspects of implementation -- as their top challenges in Meaningful Use Stage 2. "We always felt reasonably confident that the leading software vendors would successfully create the technology capabilities to meet the Meaningful Use requirements," he said. Also, he noted, the transition from Stage 1 to Stage 2 is mainly about "using the technology effectively. That's contingent on the processes and people being right, which is all about change management."
The message in this blog feels as familiar as a favorite old sweater. The old sweater is this: Until we provide training to move providers up the curve to adopting health IT in a meaningful way (there’s that word again), we’ll be overlaying 21st Century solutions on a 20th Century mindset. And it will take a generation, instead of a few quick years, to integrate a fully functional electronic patient record system into our healthcare system, leaving us to continue to grapple with the inefficiencies and duplication that our paper-based system begets.
A vignette from a recent experience with a family member’s emergency care made it clear that things aren’t quite moving apace as we’d like to believe. A member of my family had a serious health scare over Thanksgiving, one that led us to seek an opinion at a top – some might say *the* top – healthcare institution in the US. We filled out paperwork on clipboards at several visits to inpatient and outpatient facilities. The provider did not have access to the records of the other caregivers in this person’s life in another state, and there are at
least three relevant ones, so they relied on us to provide that information either from memory or physically contacting them and providing it ourselves. We carried paper files from another “modern” facility to this hospital. We required a paper prescription to be carried in our pockets for an MRI back home, after which the physical MRI film had to be sent overnight via FedEx to be read at said top healthcare institution by their expert. Huh?
I am going to say something that nobody at the General Accounting Office wants to hear, let alone the people at Health and Human Services, which is that you just spent hundreds of millions of taxpayer dollars encouraging use of electronic patient record systems that aren’t quite ready for primetime by providers who aren’t quite ready to use them. We’re peering over a fiscal cliff and staring at spending this money all over again sometime in the future on systems that are fully integrated by providers who are game to make them work.
It’s nice to be back.
Update: New government numbers out today show we've spent more than $10 billion in EHR incentives so maybe we can add an editor's note to the blog in the interest of accuracy.