ONC: Federal EHR Adoption Efforts on Track

Several federal programs that promote the use of health IT to improve healthcare outcomes are successfully on track, including the meaningful use EHR incentive program, according to Doug Fridsma, MD, PhD, director of the office of standards and interoperability at the Office of the National Coordinator for Health IT (ONC).

During his keynote address at the 2012 ICD-10 Summit on Monday, Fridsma gave an update on the progress ONC and the healthcare industry have made in adopting electronic health record systems and using them to exchange data for the improvement of care.

The number of primary care physicians who have adopted EHRs has doubled from 2009 to 2011, according to a recent ONC survey. This increase corresponds with the launch of ONC’s various EHR incentive initiatives authorized by ARRA and the HITECH Act, including direct efforts to get more physicians and hospitals to use health IT through incentives and workforce training.

“The HITECH Act was revolutionary in that it said we don’t want to pay doctors to adopt technology, we want to pay them for improved care through technology,” Fridsma said.

Both rural and urban physicians increased their EHR usage since 2009, Fridsma said, with 52 percent of the country’s eligible office-based physicians signing up for ONC’s meaningful use program.

Hospital adoption of EHRs has also doubled since 2009, increasing from 16 percent to 35 percent. A total of 85 percent of hospitals told ONC they intend to attest to the meaningful use program by 2015.

In addition to encouraging providers to implement EHR systems, ONC also launched an initiative to train workers who could implement and use those health IT systems.

In an update on the Community College Consortia, which created health IT training programs in 82 colleges across the country, Fridsma said 23,489 students have enrolled since the program launched in August 2010, with 9,017 completing the program. This is just shy of ONC’s original goal of training 10,500 health IT professionals by April 2012, though that number will likely be achieved in the near future with current students completing the program.

While the country is steadily progressing toward interoperable EHR use, more work needs to be done, Fridsma admitted.

But while it will take time, development shouldn’t be hampered by the desire to build a perfect standard, health information exchange (HIE), or EHR.

“We don’t want the perfect to be the enemy of the good,” he said. “You have to build incrementally. You can’t take 48 hours to build a 24-hour weather forecast.”

That is not to say the industry should stop innovating. For example, health information exchange is not in nationwide use. According to Fridsma, the printer and fax machine are “the state of the art in HIE” today.

But recent work on the Nationwide Health Information Network (NwHIN)—a set of standards, services, and policies that enable secure health information exchange over the Internet—will hopefully be the seed that grows a vast network of HIEs. Like the Internet, Fridsma said he hopes the NwHIN acts as a cradle of innovation for health information exchange, providing the base technology for bigger and better things to come. As of September 2011, 500 hospitals, 4,000 providers, and 36,000 users have utilized the NwHIN Exchange protocol to exchange the records of one million patients, he said. More are likely to use exchange this fall when the initiative moves from government control to a non-profit entity.

The benefit of HIE has already displayed itself through the NwHIN, with the Social Security Administration processing benefit determinations 45 percent faster since using the system.

The point of the staged meaningful use approach was to allow the healthcare industry to ease into the adoption and use of EHRs, he said.

“We are not going to be able to do this right out of the gate,” he said. “We start by turning the crank and doing informal sharing.”

Stage 1 was about getting people to adopt a standardized system and think about “what information needs to get into the system.” Stage 2 raises the bar by increasing the quality of information collected in those standardized EHR systems and requiring the electronic exchange of records. Stage 3 uses those standards for tangible and real applications that improve care, he said.

“We have made progress in the last few years and will continue to move forward,” Fridsma said. “Interoperability is a journey, not a destination.”


1 Comment

  1. I attended a ssoiesn on EHR selection at the 2010 AAO meeting. The presenters were from a large practice in the Southeast. The administrator of the practice was lawyer with tremendous business experience; they had a full time IT person. The lawyer was probably getting paid more than I am. We have a medium sized practice, 4 MDs, 2 ODs, 3 offices, and we can not afford to hire a lawyer to run our practice, or to hire a full time IT person. We did fairly thorough due diligence, we think, and decided to choose our EHR. It is pricey and complicated. We have just begun the 6 month process of implementation. It will probably be 12-24 months before we know if we made a good decision. The AAO could help by not being so vague about these products. How about an AAO analysis, a la Consumer Reports, that ranks the EHRs, shows their prices, and selects Best Buys, etc. That type of service by our national organization would be invaluable.

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