EHR, All or Nothing

American Medical News reported that doctors are pushing back on penalties for not implementing EHRs. The reason for this push back is because they feel it unfairly punishes physicians who can’t afford the up-front cost of adopting an electronic medical record system.

Although their reason has some validity, let’s not lose site of the end goal, nationwide EHRs. If the penalties are removed, physicians would no longer be on a timetable to have an EHR system implemented. This would slow down the nationwide adoption of EHRs which could force the nation into two separate systems. One electronic system, whereas patient’s medical information could be shared only if all providers in the patient’s vertical supply chain have EHRs. Otherwise, the analog system would be engaged, which is what we have now.

Surely at some point in your career you’ve had the misfortune of being involved with a project that has kept, or attempted to keep, the legacy system functioning while the new system makes it through one cycle of processing. Whether that’s a daily, weekly, monthly, quarterly, or annual cycle, what one quickly learn is after the new system has been operational for 4 or more hours, falling back to the legacy system is virtually impossible (riskier), or worst yet, its quickly discovered that the legacy system can NOT be turned off. Either scenario is not pretty.

The lesson that physicians must learned, that most IT professionals probably already know, is that negotiating to remove the penalties for providers that do not implement EHRs will be a zero-sum agreement, nationwide EHRs will not happen. When it comes to implementing EHRs, unfortunately you can’t “have your cake and eat it too.”

Read entire American Medical News article here.

Electronic Record Keeping?

Just like in any good corporate vision statement, marketing plan, and/or program a bare minimum requirement for a successful campaign is for everyone to speak the same language. To quote a former client, “everyone must sing from the same hymnal.” In a CNN article by John King (Cleveland Clinic pushes into future), he quoted the CEO of Cleveland Clinic, Dr. Toby Cosgrove, saying “he believes electronic record keeping—and sharing—will lead to few duplicative tests and other cost savings....” What is electronic record keeping? Surely he meant EHR, electronic health records.

“Why am I nitpicking, why is this important” you asked. First of all, Cleveland Clinic is not just some provider in obscurity in the Midwest. This clinic is often cited as a model of what healthcare reform would have other providers to do. President Obama quite often cites the Cleveland Clinic when talking about his healthcare reform package. The doctors and executive management team at Cleveland Clinic are frequently consulted by lawmakers, industry experts and others. So if anyone should have been up to par on the correct terminology for the administration’s reform package, Dr. Cosgrove should have been. Secondly, as President Obama’s healthcare plan gasps for air, it’s important that a consistent and clear message is articulated if his plan is to succeed. And thirdly, referring to EHR as electronic record keeping marginalizes the impact and complexity of electronic health records management. Just like the term “book keeping” does to “financial analysis.” The next time you see a financial analyst or an accountant for that matter, refer to them as a bookkeeper and see what happens.

As information technologists, whether you agree with the proposed healthcare reforms or not, you must be clear and consistent when addressing the topic of electronic health records. Now is not the time to cause confusion, it will come back to bite you. As you know, if systems are implemented when confusion is in the air IT is the function that usually suffers, or is blamed.

Read entire CNN article here.