In providing an update on his office’s activity to a National Government Health IT Summit in Washington, D.C. on Feb. 4, David Blumenthal, MD, National Coordinator of Health Information Technology, predicted that once the momentum of electronic health record adoption picks up, physicians themselves would become leaders in promoting innovation and improvement. “There will be no holding them back,” he said. “The profession will be leading us.”
“Within 10 years no physician will stand up at a meeting and say, ‘All this EHR stuff is a waste of time.’ It would be admitting they are not competent,” Blumenthal said. Using a slide of a newspaper story describing initial resistance to the use of stethoscopes, he said that historically, in medicine, when something is shown to be useful, it becomes part of the landscape. Regular use of EHRs, health information exchange and computerized decision support will become a core technical competency in just a few years, he predicts.
After outlining ONCHIT’s work to date, describing how each regulation and funding component matches up with particular healthcare outcome goals, Blumenthal discussed some of the remaining challenges:
- Perhaps the toughest is getting the definition of meaningful use right. Although there has been some attempt to be flexible in terms of when organizations can get on the “first step of the escalator,” as he calls it, the challenge is to stretch organizations to work hard on adoption without making the goals so difficult to achieve that many people don’t try or give up. (Consultants say some hospitals have already decided they will not try to achieve meaningful use and will just accept the punishment of reduced reimbursements.) This will require constant reassessment and taking seriously the comments ONCHIT receives about the interim final rules. Blumenthal sees one of his main challenges as “winning the hearts and minds” of physicians, nurses, and other healthcare providers so that they see the benefits of working toward effective use of EHRs as being worth the entry costs and adoption learning curves
- Getting the regional extension centers up and running. With $693 million to spend, ONCHIT will soon begin announcing grant winners for 70 Regional Extension Centers and more details about a national Health Information Technology Research Center.
- To promote state health information exchanges, ONCHIT will soon begin awarding $564 million to state-designated entities.
- Through partnerships with community college consortiums, ONCHIT plans to spend $118 million to help train more than 40,000 new workers to expand the health IT work force.
Noting that physician adoption rates have already started to climb and that primary care specialty societies have all endorsed use of health IT as an element of maintenance of certification, he predicts that other accreditation organizations will follow suit.
Blumenthal, whose daughter is now in medical school, said how she practices medicine will be vastly different than how physicians today practice and will greatly benefit from electronically capturing and processing information about patients; exchanging data using health information exchanges; and improved care decisions and coordination with the help of electronic decision support tools.
He says the key is to keep the focus on practice redesign and changed outcomes so that “a nurse can feel she is doing better for her patients or a physician can say my diabetic patients are doing better” because of their use of these tools.