Friday, May 09, 2014

A Pair Of Interesting Articles On The Short and Long Term Situation In The United States In Health IT.

First the short term update:

A Review of the Federal Health IT Activity in Q4 2013

by Helen R. Pfister, Susan R. Ingargiola and Erica L. Cali, Manatt Health Solutions Monday, January 13, 2014
The federal government continued to implement the Health Information Technology for Economic and Clinical Health Act, enacted as part of the American Recovery and Reinvestment Act, during the fourth quarter of 2013. Below is a summary of key developments and milestones achieved between October 1, 2013, and December 31, 2013.


The fourth quarter of 2013 saw a number of important developments:
  • HHS Announces New National Coordinator. On Dec. 19, 2013, HHS Secretary Kathleen Sebelius announced that Karen DeSalvo will be the next national coordinator for health IT. DeSalvo last served as the New Orleans Health Commissioner and a senior health policy adviser to Mayor Mitch Landrieu (D). She takes over the national coordinator post on Jan. 13.
  • CMS Proposes To Extend the Meaningful Use Timeline. On Dec. 6, 2013, CMS proposed a new timeline for the implementation of meaningful use under the Medicare and Medicaid Electronic Health Record Incentive Programs. Under the revised timeline, Stage 2 will be extended through 2016 and Stage 3 will begin in 2017 for those providers that have completed at least two years in Stage 2. On the same day, ONC proposed to allow for certification criteria to be updated more frequently under the ONC Health IT Certification Program. 
Lots more here:
Now the 10 year review:

CIOs gauge decade of health IT headway

Posted on Jan 17, 2014
By Bernie Monegain, Editor
The healthcare IT industry just marked  the 10-year anniversary of then President George W. Bush’s call to action – in his 2004 State of the Union address – to finally transform a paper-mired healthcare system into a digital-age industry that operates more like other sectors of the economy.
As we look back on 10 years, we spoke to some leaders on the frontline of health information technology, asking them to take measure of how far the industry has moved towards a truly high-tech, data-driven system of care.
Bill Spooner, Sharp Healthcare
Bill Spooner, vice president and chief information officer of Sharp Healthcare in San Diego has had an epiphany or two on his way to digital transformation. There was a time, for instance, when he advocated for best-of-breed systems. But he changed his tune when he realized there were too many interoperability headaches.
In an interview with Healthcare IT News in early 2010, Spooner addressed the issue of best-of breed technology versus enterprise systems.
He was proud, he said, of his and his colleagues’ willingness to make a change when it became clear they needed to go in a different direction on their core hospital systems, or EMR, back in 2006.
Bill Spooner“We were willing to recognize that the strategy we were taking in terms of our best-of-breed group of products just wasn’t going to bring us the value that we really needed to achieve,” Spooner said in the interview. “We began to pull out a half a dozen best-of-breed products in exchange for the integrated group of products that we are now implementing from Cerner.”
Spooner may have been early to change his tack, but today he is far from alone, with many medium and large health systems rolling out Epic or Cerner EHRs. Even pioneers in health IT are replacing their homegrown systems with commercial systems, usually with either Epic or Cerner, the two most selected enterprise EHR companies in the market today.
Partners HealthCare in Boston is in the midst of an Epic system rollout. Intermountain Healthcare in Salt Lake City recently announced a partnership with Cerner.
"We have very set ideas on how we think these systems should work, and we feel very passionately about it," said Intermountain CIO Marc Probst, in a video announcement last September. "Intermountain is committed to being innovative in the area of information systems."
Intermountain is recognized as one of the pioneers of innovation, having built its own systems from the get go to advance its data-driven approach to healthcare, which continues today.
Cerner’s open architecture technology was critical to Intermountain’s decision to partner with the EHR vendor, Probst said. Among other advantages, the open architecture will allow for the addition of the new Intermountain content. Cerner’s focus on population health was another attraction.
"We share a common vision to improve care for populations of people," said Brent James, MD, chief quality officer at Intermountain.
"This partnership will accelerate our efforts to provide core functionality to our caregivers as we create new innovations to transform healthcare,” he added, in a video announcing the launch. “By integrating the Cerner system with our electronic data warehouse, we will continue to drive improvements in healthcare quality."
At Partners HealthCare, Scott MacLean, deputy CIO and director of IS Operations, said: “We realized that much of the functionality we developed is available commercially, so we're adopting a vendor platform and will focus our innovation on genomics and other research discoveries we want to bring to the bedside and clinics.”
Sharp Healthcare’s Spooner said that today the health network has very little paper comprising the patient record. Physicians enter orders virtually, and they document online.
“The data has become actionable for care improvement,” he said.
In the not so distant past, physicians at Sharp Healthcare were not convinced the EMR was essential to the quality patient care, Spooner said. “Today they see it as indispensable to care. My challenge is to regularly bring added or improved EMR functionality, and to ensure constant availability – no scheduled or unscheduled downtime.”
Vastly more is found here with all sorts of interviews from a wide range of people:
These two provide a useful overview of where the US has been and just what they are up to. Well worth a browse.

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