Q&A: Dr. David Blumenthal On Getting Doctors On Board With EHRs - InformationWeek

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Q&A: Dr. David Blumenthal On Getting Doctors On Board With EHRs

Nation's health IT coordinator discusses what's at stake for doctors, the potential for consolidation in healthcare market, and what the government is doing to secure e-health records.

InformationWeek: Will the move to health IT and meaningful use lead to consolidation of the healthcare marketplace?

Blumenthal: That's one possibility. And there has been a tendency among physicians to go into employed situations over the last decade. But I want to make it clear that it's not our purpose or goal to undermine solo or small group practices. The acquisition of electronic health records can make those practices more sustainable over time and enable them to maintain their independence if they wish. It may be a little harder for them to get over the hump of acquisition than if they were part of a group or large organization, but they can share data with a larger organization through an electronic health record and maintain their independence using electronic means better than they could in the paper world.

InformationWeek: The HITECH act was signed into law about a year before the nation's healthcare reform legislation finally passed. Anything you now think is missing from the HITECH legislation that needs to be addressed?

Blumenthal: We will certainly learn in which ways electronic health information systems can better support health reform over time, but I think now we have a huge, very innovative mandate. If we can just do what the Congress asked us to do under HITECH, we'll have gone a long way toward making health reform more successful. I'm just hoping we can fulfill the expectations of Congress and the administration within the current HITECH authorities rather than looking forward to new pastures to graze in.

InformationWeek: In terms of mass adoption of health IT, how will it help the so-called Accountable Care Organizations? (ACOs are organizations where a doctors and hospitals manage all of a patient's care and share in the savings from providing better care.)

Blumenthal: The Accountable Care Organizations are organizations intended to hold themselves accountable to performance standards and can perform at a higher level. How do you hold yourself accountable? Through measuring what you do, looking at what you do, understanding what you do. How are you going to measure what you do without timely, accurate, comprehensive information? Where are you going to get that information in a paper world? Paper chart reviews are just not adequate. They're not accurate enough. They're not robust enough. They're not timely enough, and they're too expensive. So I think the ACO mission and agenda almost presumes the availability of electronic health information.

InformationWeek: So, if you're not using EHRS and other high-tech tools, you really can't be part of an ACO?

Blumenthal: It's possible to do with extraordinary effort. There are some organizations in the paper world that perform better than others. And with great effort and considerable cost, it's possible to document that. But the documentation has never been complete. It almost always has relied on claims data and was never adequate to really maximize the potential of those organizations and give healthcare providers with real-time feedback on their performance--the moment-by-moment kind of feedback you can get with an electronic health environment.

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