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The Starting Gun Has Sounded

August 27, 2010
by Mark Hagland, Editor-in-Chief
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Mark Hagland
Mark Hagland

On Tuesday, July 13, we in healthcare IT finally got the news we'd all been waiting for: the federal Office of the National Coordinator for Health IT (ONC) released the details on the final rule for meaningful use under the American Recovery and Reinvestment Act Health Information Technology for Economic and Clinical Health (ARRA-HITECH) Act.

That morning, as I was preparing to fly to Ojai, Calif., to attend the annual Physician Computer Symposium of the Association of Medical Directors of Information Systems (AMDIS), I listened on my smartphone as Health and Human Services (HHS) Secretary Kathleen Sibelius, brand-new Centers for Medicare and Medicaid Services (CMS) Administrator Donald Berwick, M.D., National Coordinator for Health Information Technology David Blumenthal, M.D., Surgeon General Regina Benjamin, M.D., and others, cited some of the highlights of the final rule, discussed the feds’ overall strategy and current perceptions of progress on meaningful use, and answered questions, at a press conference in Washington, D.C. They were also joined by a special guest, Regina Holiday, a woman whose husband, while dying of cancer, experienced severe compromising of his patient care because of a lack of electronic health records (EHR), and whose compelling story underscored the very critical issues at stake for all of us.

Not surprisingly, of course, the final rule on meaningful use dominated discussions at the AMDIS symposium. In fact, Dr. Blumenthal spoke to the attendees remotely the next morning, and Farzad Mostashari, M.D., senior advisor at ONC and apparently the agency's No. 2 public representative after Dr. Blumenthal, spent a good bit of time in person at the AMDIS symposium, answering a broad range of questions from the attendees. Dr. Mostashari seemed very open to the perspectives and concerns of the assembled group, and it certainly struck me as a good sign that he could wade so comfortably in the midst of the chief medical information officers gathered in Ojai at that critical moment in time, and leave the audience with a very positive impression.

Since then, every expert on meaningful use (and an army of self-identified experts) has weighed in with his or her perspectives on the final rule. It seems to me, overall, that ONC and HHS have gotten things largely right at this moment, particularly with their increased flexibility around certain granular requirements within the final rule, and the feds’ Solomonic approach to an extremely thorny basket of challenges.

So Now We Know. And now begins the really hard work, of taking the complex set of requirements laid out in the final rule and turning those into the reality of the new healthcare of improved patient care quality, patient safety, efficiency, transparency, accountability, and connectivity that everyone agrees needs to come into existence. The question is: are you and your organization moving forward as needed, with the right combination of vision, strategy, tactics, commitment, and resources? In our cover package on meaningful use in this issue, we look at the broad issues ahead on the long road towards 2015; speak with the CIOs and clinical informaticist leaders at a number of pioneering patient care organizations whose foundational work towards the new healthcare has positioned them optimally with regard to meaningful use; and examine the issues around helping physicians achieve meaningful use.

We will continue to report on and analyze all the elements of and developments in meaningful use going forward, for you, our readers, both in the print editions of our magazine, and on our Web site. The bottom-line question: how will your organization fare? At the very least, you certainly can no longer say that You Didn't Know.

Mark Hagland, Editor-in-Chief Healthcare Informatics 2010 September;27(9):6