Friday, October 10, 2014

This Has The Feeling Of Something That Might Be A Big Problem In The Making.

This appeared a little while ago. To follow up on a post on this Forbes blog from a day or so earlier!

Health Data "Interoperability": A $30 Billion Unicorn Hunt

John R. Graham , Contributor
Having cheered as $26 billion of taxpayers’ money has been spent since 2009 inducing hospitals and physicians to install electronic health records (EHRs), many champions of the effort are dismayed that the EHRs are not interoperable. That is, they cannot talk to each other – which was the whole point of subsidizing the exercise.
All this money has achieved a process goal: There has been a significant uptake of EHRs. According to a recent review, the proportion of physicians who have at least a basic EHR has increased from under 22 percent to 48 percent. Doctors were motivated by the bounty offered, plus the threat of having reimbursements being clawed back in 2015 if they have not adopted EHRs. The proportion of hospitals has similarly increased from 12 percent to 44 percent.
But these EHRs do not  talk to each other. According to the same review, “only 10 percent of ambulatory practices and 30 percent of hospitals were found to be participating in operational health information exchange efforts.”
All those billions of taxpayers’ dollars were paid out to providers who attest to “meaningful use” of EHRs. However, there are three stages of meaningful use.  Stage 1 was relatively simple. Stage 2 was originally supposed to be achieved by 2013, but that has been pushed back until 2016. The hang up is that stage 2 has a high hurdle for interoperability.
According to the final rule published in September 2012, requirements include “the expectation that providers will electronically transmit patient care summaries with each other and with the patient to support transitions in care. Increasingly robust expectations for health information exchange in Stage 2 and Stage 3 would support the goal that information follows the patient.”
Lots more here:

Elsewhere we are hearing those claiming the incentives for Stage 2 are far fewer in number. Is this all a harbinger of doom - or will it correct itself over time. One really has to wonder if Stage 2 might just have been a level of overreach. Time will tell!


p.s. Just love the term "Unicorn Hunt"!

1 comment:

Anonymous said...

A Unicorn Hunt is the perfect analogy. Anyone who believes that underlying technical problems are is what is holding up health system interoperability is in dreamtime.

We have the same problem in Australia. The big corporates eg labs need health system efficiciency and cost reduction like they need a hole in the head and so have spent years and huge resources underminining it.

It is time for Canberra's unicorn hunters to get off their gilded lillypads, stop chasing fairy down and willow-the-wisps and get real.