Government Health IT Push May Need to Circle Back

As part of a push to promote information technology, the health IT czar announced plans Wednesday to track how many physicians are using EHRs.

Starting in 2006, Massachusetts General Hospital and Harvard Institute for Health Policy and George Washington University will prepare a series of annual reports that will gauge whether policies that encourage use of interoperable EHRs (electronic health records) are working.

The reports will measure EHR adoption across a range of settings, patient groups, and practice sizes.

The announcement is the latest of a series aimed at getting doctors and nurses to use health information technology, including plans to modify anti-kickback laws that curtail programs to help physicians acquire health information technology.

Some $40 million in grants has already been awarded. These included grants to work out common standards and certification programs across the nation to ensure different health IT products can work together. Other grants help communities move forward with individual health IT projects.

The two kinds of grants recall a standing debate over whether a nationwide effort should be first undertaken to resolve conflicts or whether health IT systems should be allowed to grow organically. The government seems to be taking a kind of hybrid approach.

Even within a single institution, lack of interoperability is a huge drain on productivity, he said.

“One vendor may sell a suite of applications that don’t talk to each other; hospitals have sets of applications that don’t talk to each other,” he said.

“It’s not just between outpatients and hospitals; they are keeping people from doing their job within one hospital.”

Standards are essential for health IT vendors to invest in improved products and for health providers and payers to feel comfortable paying for the technology, said Jim Hansen, vice president of research at IDC’s Health Industry Research.

Other grants announced were aimed at fostering individual health IT projects, many fostering communication between different providers in small or rural communities.

David Brailer, the health IT czar, has often said that such projects could function as individual laboratories that could show unanticipated ways that health IT projects could alter clinical work flow and health care.

Hansen agreed, but worried that some of the communities could be left stranded if the solutions they implement conflict with the standards that are eventually adopted.

“My concern is they’re building in areas where standards still need to be finalized, so the system they put into place won’t be up to date.”

He admitted that health IT could be stalled perpetually if developers waited for standards to fall into place, but said that he hoped the government would protect the first movers, particularly ones from cash-strapped areas.

“When standards get finalized, there should be funding that comes back in and helps communities come back in and retroactively change it to be in line with the standards.”