Ignoring the current firestorm concerning health care reform that is sweeping the country; I would like to focus on the major health care event of 2009 that seems to have slipped under the radar but is the cornerstone of all future health care reform.
As part of the stimulus package known as the American Recovery and Reinvestment Act, the President signed the Health Information Technology for Economic and Clinical Health (HITECH) Act. This act includes billions of dollars in incentive payments through Medicare to digitize and automate the health care industry starting in 2011 and going until 2015, with the goal of providing the platform for the implementation of a nationwide interoperable, privacy-protected health information technology infrastructure. What this infrastructure will be is being worked out now by various committees established by the National Coordinator for Health Information Technology, Dr. David Blumenthal, M.D., M.P.P.. However, the starting point for these committees was defined, and incentive payments will only be dispersed if providers meet the following high level tenets:
- Use a “certified” Electronic Health Record (EHR)
- Demonstrate “meaningful use” of an EHR
- Use e-Prescribing
- Electronically exchange information
- Submit clinical quality measures
‘Meaningful use’ as broadly outlined in the Act is being refined and a final definition is scheduled to be released by the end of the year.
What has become crystal clear as the committees report back is that the focus and drive of the implementation of the nationwide infrastructure will be in the sharing and communicating of health data? What does this mean for health care IT and anyone involved in the health care industry? Within five years it is expected that 90% of the provider community will be using an EHR system; current estimates have the level of EHR use at between 2-4%. This is a staggering amount of work within a relatively short period of time. The transformation of health care from an inward to an outward facing industry is highly complex and revolutionary. Foundational technology MUST be implemented that can support this transformation. Data Integration, Identity Resolution, and real time event analysis are core technologies that will be the engines that drive the successful health care organization in this new way of delivering services.
Identity resolution’s goal is to find the right person at the right time, regardless of the potential for error and variation in what information is available at the time of request. This could be during patient registration and admission, patient transfers or referrals, emergency room visits, and simply sharing information across providers or insurers. The ability to do this effectively must become the most basic and core function. Imagine 2015 and 90% of all health care data is being shared on the national information exchange: does your organization want to be the one that shares mis-identified customers? The hard truth is if you can’t handle identity data, how will other organizations, and more important your customers, have trust in the clinical data that is being shared?
I have spent many years dealing with identity resolution first within a public health setting and then in a large IHDN (International Health and Development Network), at first it feels like an overwhelming task, costing millions and requiring countless hours of human capital. The truth is a lot less scary.
In addition to the benefits stemming from identity resolution, two other key benefits that are promised as a part of this evolution are the same as we have heard all summer:curb costs and improve patient outcomes.
The advent of “evidence-based medicine” is a great example of how Information Technology can be applied to potentially achieve both of the aforementioned goals. For those that aren’t familiar with this term, it is essentially the notion that you measure what works (and what doesn’t) and use this data to make more consistent accurate decisions at the point-of-care. It is a great example of how shared information can and will benefit all involved in healthcare delivery across America.
If you want to hear more from me on this, register here for the webinar entitled Get To “Meaningful Use” Faster … next Tuesday, September 22nd at 2pm EDT.
Al Porco, Former CIO, Kings County Hospital
Al is one of the world’s foremost experts in Healthcare IT with over 20 years of experience. As CIO of Kings County Hospital he was responsible for the entire modernization of IT infrastructure and software for more than five years.