line data from the days of paper records, Tang says.
However, many organizations continue to tout the EHR’s ability
to provide clinical decision support, says Katherine Lusk, MHSM,
RHIA, FAHIMA, chief health information management and exchange officer at Children’s Health in Dallas, TX. For example, the
quality of care undoubtedly improves as EHRs alert providers of suspected conditions based on the presence of symptoms, she adds.
Although the internet is rife with EHR success stories, Miller
says providers must continue to speak out about the benefits of
EHRs. In the absence of formal studies, these anecdotal stories
help prove the business case for the technology, she adds.
Redefining ‘Successful’ Health IT Adoption
Prior to the meaningful use program, successful health IT adop-
tion meant simply increasing the number of providers using
EHRs. Now that the industry has achieved this goal, many are
starting to wonder what’s next and how healthcare should re-
Experts agree that the health IT industry will reach the next
phase of successful adoption only when providers begin to
think of the EHR as a conduit for the valuable health informa-
tion that’s stored inside.
This view of the EHR reflects the fact that healthcare increasingly occurs beyond the four walls of a hospital or physician office. In addition, most patients don’t stay within a single healthcare system throughout their lives, Frisse says.
“It’s time to move away from the EHR as the center of the uni-
verse and focus on the broader system of care,” Frisse says. “The
central element is the information people need and the data
that needs to be sent.”
Interoperability will help achieve this goal, Lusk says, whose
vision for successful health IT is one of true accessibility. “It’s
about going anywhere in the world and having my medical in-
formation available in real time for clinical care providers who
have access to decision support and best practices that guide
my care,” she says.
Widely-adopted standards pave the way for interoperability because they allow different EHRs to exchange information
in a trusted and consistent format, Lusk says. When providers
trust the data they receive electronically, they’re able to reduce
administrative costs (i.e., costs associated with data entry and
scanning), avoid duplicate tests, and make more precise diagnoses. Lusk provides the example of RxNorm, a medication
data standard that assimilates various pharmacy vocabularies.
RxNorm helps organizations share patient medication history,
decrease data entry, and increase clinical accuracy.
Successful health IT also incorporates more advanced analytics
capabilities, helping users immediately draw insights from raw
data, including genomic data, socioeconomic data, and patient-
generated data, Tang says. “Successful HIT would be if the com-
puter provided insights and answers to the questions that I have
about a patient,” Tang says. “Artificial intelligence companies like
IBM will want to partner with EHR vendors to help add this func-
tionality to what they do.”
Finally, vendors must continue to do the obvious—make and
keep end users happy. This includes providers as well as pa-
tients, Tang says. “In defense of the vendors, they were asked
to do something very quickly,” he says, referring to meaningful
use efforts. “Now is the time to work on improving usability. This
would help contribute to successful [health IT] adoption.”
Identifying a National Vision for Continued Health
As the meaningful use program winds down, experts say there is
no single national program in place to ensure continued health
IT progress. However, various efforts are underway to keep providers focused on interoperability and using health IT to improve the quality of care.
For example, the 21st Century Cures Act enacted in December
2016 includes a section on health IT interoperability that not only
calls for complete access to health information (including standards that allow EHR queries) but also prohibits information
blocking. More specifically, the legislation says vendors cannot
configure their products to “prevent or materially discourage the
access, exchange, or use of electronic health information.” 3
The National Academy of Medicine (NAM) has also weighed
in on creating a national vision for continued health IT implementation by publishing a series of discussion papers that include input from more than 150 leading researchers, scientists,
and policymakers nationwide.
“They set forth a good overview of everything we need to do—
where we are now and where we need to go,” says Frisse, one of
the contributing authors. “They’re high-level, but I think that’s
what we need.”
For example, in its March 2017 discussion paper titled “Vital
Directions for Health and Health Care: Priorities from a Na-
tional Academy of Medicine Initiative,” experts advocate for the
federal government to take various steps to improve interoper-
ability. 4 These include:
Create policies that encourage vendors to adopt data standards and facilitate data sharing.
Design and promote value-based payments that de-in-centivize unnecessary and duplicative services that contribute to avoidable waste and inefficiency.
Develop incentives, clinical practice guidelines, and decision support tools that encourage physicians to engage
each patient in clinical decisions.
Support a voluntary national patient identifier that would
facilitate patient data matching and overall data aggregation.
Support end-to-end interoperability through federally
facilitated or mandated efforts, or through direct federal
action, that allow private and secure data transmission
among EHRs and Food and Drug Administration-ap-proved medical devices.
Should the industry be concerned that there isn’t more of a
clear federal plan in place to continue forward momentum? Not
necessarily, Halamka says. “There isn’t going to be a top-down
government-driven plan to do this,” he says. “It’s the industry
recognizing there’s an urgency for doing this. I actually think
we’re going to see the private sector blossom with innovation.”
Halamka is referring to apps and other add-on solutions that
will enable interoperability and enhance the user experience.
When asked whether these apps and added functionality will