Reporter's Notebook: The health care community has reached a broad consensus on the use of health IT: that the cheerleading is starting to wane and the time of real, nitty gritty work is waxing.SALT LAKE CITY—"The products have increased, but the fundamental issues are the same." That's how Richard Ward, CEO of Reward Health Sciences, Inc. summed up this year's Toward an Electronic Patient Record conference.
When he last attended the conference in 2001, Ward made a list of what he considered the fundamentals and unchallenged assumptions of health IT at that time.
Since then, wireless has indeed emerged as an enabling technology, but the perceived need for handheld devices has decreased.
Other beliefs, like standards being a barrier to widespread adoption and the sense that technology should change doctors' routines as little as possible, still seem to hold.
As for the content of this year's conference, Ward said he felt there was still too much emphasis on a limited view of IT as a "paperless, fingertip access to information," but that he was heartened that broader topics were included in sessions and some keynote speeches.
"Workflow automation technology is of great importance. And for the first time, there was an actual track about the topic." Still, he said, "very little was on point."
A few people said that the health care community had reached a broad consensus on the use of health IT: that the cheerleading was starting to wane and that the time of real, nitty-gritty work is waxing.
The conference themes support this notion. This year's was "The EHR Era Has Begun: Is Your Organization Ready?" Last year's: "2004 is the Year of the Electronic Health Record."
People also repeated their impatience with a surfeit of standards and the poor penetration of health IT.
"Sometimes, it doesn't matter if a standard is perfect. Just give me one," said one panelist.
"My grocery store knows more about my purchases[than my doctor does]," said one attendee, who added that he was eager to start using the data to improve public health.
Other common topics were the need for seed funding and evidence that EMRs were good investments. The potential for patients to establish personal health records and exchange data with their doctors was mentioned in several sessions.
So, too, were possibilities for health care providers to exchange information with each other through RHIOs (regional health information organizations).
Though several RHIOs have been established, three or four session leaders remarked that they were buoyed by seed funding and lacked a viable business model.
Greater potential for data exchange means greater potential for patients' data to be misused. Some said they wanted the government to take firmer stands on issues like patient privacy; others disagreed, saying that HIPAA, though written with good intentions, had turned out to be good only for lawyers and consultants.
The most talked-about disappointment at this year's Toward an Electronic Patient Record conference was its keynote speaker. Or rather, his absence. David Brailer, the nation's health IT czar, canceled his appearance here for a meeting at the White House.
Most of the clinicians interviewed at the conference had not yet adopted electronic medical records and saw the conference as a way to become better-informed consumers. Several said they had hoped to find inspiration from the talk.
"I want my money back," said one pediatrician upon hearing the news.
Last year, TEPR marked the newly appointed Brailer's coming out party," and he seized the bully pulpit to urge clinicians to adopt technology. Since then, he has had a grueling schedule with nearly nonstop appearances across the country.
The panel on government initiatives on which Brailer was expected to appear was sparsely attended.
Electronic gadgets of all sorts were popular with attendees. More than once, participants passed USB drives around to share PowerPoint presentations.
Wireless hotspots kept attendees online throughout the Salt Palace Convention Center.
Health Care 
