Last week I was fortunate to attend the annual meeting of the Office of the National Coordinator (ONC) for Health Information Technology (HIT) in Washington, DC. The theme for the day was “Transforming Healthcare One Connection at a Time,” indicating a focus on how HIT is impacting the healthcare delivery system through innovation and interoperability.
The agenda for the meeting included remarks from the new National Coordinator, Karen DeSalvo, as well as appearances by the Secretary of Health and Human Services, Kathleen Sebelius, the Secretary of State for Health of the United Kingdom, Jeremy Hunt (via webcast), and the Acting Surgeon General, Rear Admiral Boris Lushniak. All of these heavy hitters spoke broadly about HIT and its impact. DeSalvo cited her experiences in New Orleans, recalling, “(Hurricane) Katrina brought home to me that the EHR is not just an important tool in health care delivery, but also in public health.” Lushniak continued the theme of connecting HIT to public health by asking the attendees to further his mission to protect, promote, and advance public health by using data captured through HIT to fight preventable diseases. Sebelius emphasized how important HIT is to future research and decision making by signing a memorandum of understanding between the United States and the United Kingdom to “lay the groundwork for an unprecedented amount of data sharing” around quality indicators, as well as for standards development around data capture and interoperability.
Other sessions throughout the day were primarily panel discussions on current issues in the HIT community. In the first session, the panel discussed how several healthcare organizations have used Health IT to improve patient outcomes and workflow efficiencies. When talking about setting realistic expectations for HIT implementation, a panelist said it was like getting engaged and being asked when you are going to have a baby. Putting a new system in place is one thing, but optimizing features and workflow takes additional time and effort. The panel also discussed inherent inefficiencies in the 150+ quality measures that must be reported in different ways to multiple agencies, and ONC indicated that they are working with CMS to get better alignment of these measures so each provider can report once and the reporting will count across multiple payers.
The next panel on spurring innovation encouraged HIT vendors to develop great ideas that will empower providers and patients. However, they reminded us to think about the level of risk the technology might introduce into the organization when implemented. What would go wrong if the technology breaks? HIT vendors need to be mindful of how patient safety may be impacted and put safeguards in place to minimize risk. The conversation shifted to workflows as a panelist observed that building technology is easy, but changing workflows is really hard. Often, the bigger challenge for HIT is the human element of managing change and encouraging new habits.
The last two panel discussions were on building safer systems and making progress toward interoperability. The panelists agreed that as patient access to personal health records increases, the demand for data and documentation quality will increase. Although HIT can facilitate, enhance, or make matters worse in patient care, when it is well-designed, implemented, and used appropriately, it has the potential to enhance care quality through clinical decision support. One panelist reminded the attendees that HIT puts patients at risk when they don’t consider how the information will be shared across care systems and teams. The panel emphasized that HIT vendors need to collaborate with healthcare providers in designing systems that fit workflow to optimize accuracy, clarity, and completeness of both data and narrative.
During the last panel, a participant defined interoperability as the exchange and use of information. Further, he emphasized that interoperability is not about the technology that sends or receives information but what you intend to do with the information being transmitted. The idea is to be able to use the information captured by HIT in multiple ways and to learn from it. However, a current challenge is to get EHR vendors to open up their interfaces and get connected to other systems at a reasonable cost to providers. The provider community doesn’t necessarily want a deep dive into the details of HL7, HIE, etc., but they want integration that works. The panel encouraged HIT vendors to work together to create interoperability standards and get patient data moving.
The ONC annual meeting presented a lot of information and ideas in a very short amount of time, and I am glad I was able to participate. As a representative of 3M’s document creation products, I was glad to hear that our efforts around data and documentation capture are in alignment with the HIT industry, especially our engagement with clients to design software that optimizes workflow and accommodates interoperability with other HIT vendors. This meeting emphasized that there is much more work to do, but we are on the right track.
Jill Devrick is the AHDI President and a Product Solutions Advisor with 3M Health Information Systems.