Dr. John Halamka, Chief Information Officer for Beth Israel Deaconess Medical Center, records his experiences with infrastructure, applications, policies, management and governance.
For years, patients, providers and payers have complained that EHRs "do not talk to each other"
By 2014, I expect this issue to disappear.
Do I expect that every state and territory will have a robust, sustainable healthcare information exchange by 2014? No
Do I expect that every provider will be connected to a Nationwide Health Information Network by 2014? No
Do I expect that a single vendor will create a centrally hosted method to share data by 2014 just as Sabre did for the airline industry in the 1960's? No
What I expect is that Meaningful Use Stage 2 will provide the technology, policy, and incentives to make interoperability real.
Stage 2 requires that providers demonstrate, in production, the exchange of clinical care summaries for 10% of their patient encounters during the reporting period. The application and infrastructure investment necessary to support 10% is not much different than 100%. The 10% requirement will bring most professionals and hospitals to the tipping point where information exchange will be implemented at scale, rapidly accelerating data liquidity.
Stage 2 requires that more than 5 percent of patients with inpatient or outpatient encounters (or their authorized representatives) to view, download or transmit to a third party their information during the EHR reporting period. The Automate Blue Button initiative is an example of this functionality. It puts the patient in control by enabling query/response or publish/subscribe retrieval of care summary data from EHRs. Just as the 10% threshold for exchange of summaries between providers will encourage technology and policy implementation, the 5% threshold for patient-provider exchange means that software, educational materials and processes will be put in place to engage patient and families in novel ways. If not, hospitals and professionals will not qualify for stimulus dollars.