Last week I was reminded about how far we’ve come in electronic patient records in just three years, when the annual signature event in health IT, the Health Information Management Systems Society conference known as HIMSS (pronounced HIM-Z), was held. Three years ago I spent the week at HIMSS10, and at that time we hadn’t even started up the Meaningful Use hill, let alone crested MU2.
Since then, we also have seen uptake rates for electronic patient records and CPOE topping 50% in most provider venues without even breaking a sweat. And, in my humble opinion, the leading news out of HIMSS13 was the fact that six leading electronic patient record systems will be working together on establishing standards to advance interoperability. Whew! Never thought we’d see that in the first half of the 21st century…
The progress is commendable. And as a long-time observer and analyst in this field, while the cynic in me often says, “We wrote white papers about that 20 years ago…it’s about time!”, the realist knows that fully integrated electronic patient records requires a kind of sea change in the way we provide service to patients – and that will only come over time with changes in culture, which is why I have been talking about change management and training as absolutely essential for a smooth transition – something that studies are bearing out (see my Healthcare Talent Transformation blog post from last month).
But probably the biggest single factor in moving the needle on uptake is the more than $10 billion we spent in incentives over the last few years to encourage doctors and hospitals to purchase the software systems. Unfortunately, after those billions have been spent, only now are the top vendors getting together on establishing standards for interoperability. I haven’t read the fine print, but I will guess that those are probably not going to be free upgrades to those systems the tax payers already bought and paid for. I would love somebody who knows about the interoperability effort to post here with more details since time to publish does not allow me to do the research. In the meantime, I might do a little looking and report back in a few weeks, so stay tuned.
But the bottom line on the advantages of electronic patient records boil down to a few major points, and at HIMSS13 it is clear we have finally started to move the needle on some of these:
- Uptake rates for physicians, hospitals and computerized order entry (pharmacy, radiology, etc)
- National (international would be *really* nice) standards for interoperability
- Fully integrated patient record including dental, vision, mental health (we’re a looooong way from this one, but it is critical to getting a good end-to-end snapshot of the patient in front of us. Only ONE booth at HIMSS10 even offered software for mental health providers and, no, it wasn’t integrated into the major software packages)
- Ability to pull aggregated, de-identified data for research for full population studies and post-approval FDA studies
The Falling Cost of Technology – Except in Healthcare
As envisioned by the planners, when we can capture the full picture of a patient, and all providers have access to it, theoretically the cost of healthcare should fall quite a bit. No more duplicate tests, the cardiologist will know what the psychiatrist prescribed so we won’t have the drug-drug interaction issues that currently cost us at least hundreds of millions a year in adverse events and the attendant morbidity and mortality rates, we won’t be writing and re-writing scores of sheets of repetitive patient documents for each provider and patient encounter and having to physically store and transfer them. And, the icing on the cake, when we have valid, comprehensive data on full populations, we should know what works in which patients which will narrow our treatment options to the ones most likely to succeed the first time.
Technology usually brings with it a falling cost curve. But the reality is, for now, we are still undergoing the transformation stage and the transition is rocky and costly. The culture is still changing, the records are still isolated in single offices or hospital systems, and we haven’t completely solved how to interact with patients using an electronic interface in the room, and especially, we haven’t solved how to take and capture complex notes in an electronic record.
We aren’t there yet. But reports out of HIMSS13 suggest we are getting there.
If you were at HIMSS13, we’d love to hear from you in the comments section. And if, like me, you missed it, let me shamelessly hustle what sounds like a great deal which is a three-hour debrief today, Wednesday March 13 from 11 a.m. to 2 p.m. CST and access to full sessions online until June, Here’s the link: HIMSS13 Online Sessions
And, what’s more, the online sessions are eligible for CE credits.Let me know what you think about HIMSS13, and I’ll be reporting back when I learn more.