Dr. Dan Morhaim offered some constructive criticisms about electronic medical records in a September 27 Washington Post opinion piece (“An electronic medical records mess”). We couldn’t agree more with his call to provide instant access to patient medical history. As one of the companies out there developing electronic health record (EHR) systems, we understand his frustrations. But we hope he, and the thousands of other providers and physicians transitioning into this new era, will view these changes with some historical perspective about how technologies evolve — and some optimism about what’s possible.
Dr. Morhaim’s praise for the Veterans Health Information Systems and Technology Architecture (VistA) is well-placed, but his call to put a “moratorium on implementation of electronic health records programs and review where things stand, with the goal of implementing a uniform, user-friendly system” overlooks the, yes, “messy” but necessary realities of technology development.
The “mess” Dr. Morhaim cited simply reflects where EHRs are in the classic technology adoption lifecycle. Iowa State University sociologists first articulated that lifecycle in 1957 to explain changes in agriculture and home economics, but it can be seen in the evolution of every new technology.
EHR adoption is no different than, say, the history of the Internet or online shopping. The early days held plenty of glitches, frustrations, impediments, and inefficiencies. And so it will be as our healthcare system progresses from paper to digitized systems. It’s part of the iteration process.
Change is especially complicated in healthcare, with so many dependencies, interactions, variables, and audiences involved. But that makes it even more important that we DO digitize — and do so well.
We are nearing an important tipping point: 80 percent of hospitals and more than 50 percent of eligible professionals have adopted EHR systems. That’s a nearly 900 percent increase among hospitals since 2008.
As EHR adoption advances, we can make it better by creating tools that connect patients and providers with the digital records that are now available. To achieve the “meaningful” part of the government’s Meaningful Use mandate for EHRs, leading edge companies will offer interactive data visualization tools that bring personal health records to life, enhance comprehension, and make that data actionable and shareable.
That’s where the efforts of the Office of the National Coordinator for Health Information Technology (ONC) and vendors who support standards-based data sharing tools come in. Some key game changers include Blue Button Plus, wide adoption of CCDAs, and the DIRECT protocol. We need user-friendly, intuitive tools like InstantPHR™ that patients and healthcare providers can use to tap into those digital records and pull out the information most relevant to them.
The Meaningful Use program itself takes into consideration the iterative nature of technological development. MU is incremental, with each stage laying the foundation for the next. It’s impossible to evaluate the success of the program without seeing it through to its completion. That would be like judging the omelet before the eggs are cooked. Unfortunately, cooking eggs and iterating technology both tend to be messy.
Get Real Health designs our systems with one goal in mind: to improve outcomes for patients. We know our clients share that goal, which is why we build clinical input into every aspect of our core product development and client-specific implementations.
Dr. Morhaim’s public feedback about EHRs, as a physician and legislator, is helpful. As we all share the messy but vital journey from paper to digitization, we have two requests: keep the constructive criticism coming, and — as they say at construction sites everywhere — please “pardon our dust” as we build the future.