HealthHarbor: Health IT stimulus leads to more questions than answers

The following is a reader take from the staff at HealthHarbor.

We had a chance to attend the HIMSS conference two weeks ago. HIMSS is healthcare’s premier annual tech expo, and was in Chicago this year. The undeniable theme of this year’s conference was the anticipated expansion of Health Information Technology (HIT) via the Economic Recovery Act. Among the hundreds of vendors, seemingly 70% or more were touting their ability to create electronic medical records, personal health records, telemedicine applications, or interoperability capabilities. There was an eclectic mix of the large usual suspects with smaller startups hoping to hitch their wagon to this HIT momentum. The conference also consists of hundreds of seminars and sessions, and any session focusing on either Stimulus money or electronic medical records were full. It was a landslide ““ people wanted to hear about the next generation EHRs and how they are going to change the world.

There is no doubt that billions of Stimulus dollars will help spur the expansion of HIT and EHRs. After attending the HIMSS conference, however, we concluded that our time there resulted in more questions than answers. Here are three burning questions that we walked away with, and that we don’t see firm answers on anytime soon:

1. We all agree that interoperability of EHR systems will be needed, but whose standard will win? On the hospital side there are dominant players in the EHR field who will claim to have the standards for interoperability with doctors, dentists, clinics, and pharmacies. It seems that government, however, should not be a kingmaker in picking a private firm’s product to be the standard. We also heard a lot about the interoperability between the VA and Department of Defense ““ perhaps this naturally becomes the interoperability standard since it is already sponsored by the taxpayer. Finally, there was at least one presentation given on how interoperability technology should actually be open-source, allowing it to adapt quickly to whichever dominant EHR technology prevails. We know one thing ““ whatever the interoperability standard is, it needs to behave like bank ATMs. If I’m in Fresno and want to withdraw funds from a bank in Charlotte, I can do it, and I couldn’t really tell you how it happened technologically.

2. Will telemedicine ever really take off? A surprising number of vendors at the HIMSS conference were touting their ability to use technology to connect clinicians and patients through telemedicine. The problem is that we’ve been hearing that for years, whether it is Medtronic having devices that, through a phone line, can help determine if the devices are working correctly, to the vision of e-connecting with physicians being able to dramatically reduce the number of office visits. Perhaps the real future of telemedicine is an enhanced version of what patients have today in the decades-old dial-a-nurse concept ““ the ability to contact their provider to learn if they should be alarmed by a symptom they are having, but making it more streamlined.

3. Do we need to be more opportunistic about this? What Stimulus will do is force the issue. In HIT business opportunities where the value proposition was once marginal, it may now be squarely positive so we’ll see a more rapid build out of certain technologies. But one has to think that while the time may be right for rapid deployment of some technologies such as e-Prescribing, with its patient convenience and reduced error rates, for other technologies we still aren’t “there”.

HealthHarbor is an online source of consumer health information.

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