Judy Murphy, R.N., deputy national coordinator for programs and policy at the Office of the National Coordinator for Health IT, says criticisms of the EHR incentive program because it hasn’t yet led to widespread interoperability are misguided.
In her keynote address, at last week’s Mid-Atlantic Healthcare Informatics Symposium in Philadelphia, Murphy noted that members of Congress, most recently six Republican senators, have asked whether we are getting our money’s worth from the program, focusing in on health information exchange. “But that’s not what we were trying to accomplish in stage 1. Stage 2 is about patient engagement and interoperability,” she said.
She updated the audience on the most recent numbers from the EHR incentive program. She said $14 billion in total payments have been made. The number of hospitals registered for meaningful use has grown to 4,300 or 86 percent of those eligible. The number of hospitals using CPOE has grown from 27 percent in 2008 to 72 percent today. But interoperability, she told the 330 attendees, “is going to be a progression, a journey.”
Looking ahead, she said patient engagement and the concept of a patient-centered heath record would be a key ONC focus. “The concept has nothing to do with health IT," she said. "It has more to do with the way we practice. Today we practice in silos. We don’t create care plans that move into the community.” The way for health IT to support this new way of practicing is to get electronic systems talking to each other through standards creation, she added.
She noted that Stage 2 will present challenges to providers in proving they can do transition of care summaries to providers using different types of software. “The fun will begin Oct. 1,” she added.
One of the themes of the conference was patient access to their own health data. Murphy noted that there are now online immunization registries in 48 states, and only three allow access by patients. “It’s a travesty,” she added. “It is time to open the kimono. It may require some extra security work, but it is time for them to get it going for patients.”
Murphy said big challenges still lay ahead for ONC and for our health system in general. It is a big shift from data capture in Stage 1 to working on improved outcomes in Stage 3. We need to become a learning network, she said, so evidence being gathered in the care circle lead to improvements in quality.
Murphy’s talk was followed by a panel discussion on the future of informatics led by Kevin Fickenscher, M.D., president and CEO of the American Medical Informatics Association (AMIA).
Marc Overhage, M.D., Ph.D., chief medical informatics officer of the Health Services Business Unit of Siemens Healthcare warned that the drop-off in government grant support for informatics research is troubling. “Research, is at high risk now,” he said. “Funding is constrained and getting worse. The emphasis is on application. But we are in danger of losing a generation of informaticists going forward. It concerns me greatly.”
The symposium, put on by the Children’s Hospital of Philadelphia, was also the site of the first meeting of AMIA’s first regional chapter, which covers the Philadelphia region. Fickenscher noted that several other regional chapters are in the works.
In the next few days I will have another story on some presentations about data analytics innovations. It was a great meeting!