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EHR
EHR 2.0: Thinking Outside the Cat Box
One of the potential dangers of limiting $17 B HITECH federal stimulus funds to electronic health records (EHRs) is the risk of locking-in outdated technologies. Let’s consider what this might mean.
If you think of today’s EHR technology as EHR 1.0, what might EHR 2.0 look like? This post presents a number of innovative ways to conceptualize EHR 2.0:
EHR as Platform + Applications
EHR as Clinical Groupware
EHR Integrated with PHR
EHR as Software-as-a-Service (SaaS)
EHR as a “Publish-Discover” Search Engine
EHR + Disease Management Services = […]
Stand for Quality Group: “Link HIT Investment to Quality Improvement”
On March 24, Stand for Quality — a new group representing 165 diverse health care organizations — called for a new era of quality in health care. Their white paper is titled Building a Foundation for High Quality, Affordable Health Care: Linking Performance Measurement to Health Reform .
The perspectives of Stand for Quality are a remarkable break from the past and have significant implications for future […]
Wait and See: What’s Unclear or To-Be-Determined (TBD) About HITECH.
Sometimes laws are passed and the statute itself represents 95% of the work — there aren’t many details to figure out or loose ends to tidy up.
That isn’t the case with HITECH. The HITECH statute is just the beginning.
Whether you’re a cat or a dog, you’ll have hopes and fears about aspects of HITECH that are unclear or yet to-be-determined (TBD).
These include:
Feline Foot-Dragging: Three Non-Innovative Aspects of HITECH
What do cats (incumbent EHR vendors and their supporters) have to smile about over HITECH?
A lot.
…and it’s not very complicated. HITECH directs $17 B to the cat community, and leaves scraps for the dogs.
(As a refresher, the cat POV is that HITECH stimulus funds should simply pay directly for electronic health record (EHR) technology — that providers will figure out how to use the technology to improve quality and outcomes; the dog POV is that HITECH should pay for improved […]
Dogged Optimism: Five Innovative Aspects of HITECH
If you’re a dog (an innovator), what’s there to smile about over HITECH? Quite a bit.
In the first post of this series, I suggested that HITECH favors cats by about 60/40 and noted that the single most cat-like feature of HITECH is providing incentives for physicians and hospitals to acquire and implement EHRs — but only EHRs. Reader “Mark” commented:
“How does this work out to 60/40? Looks to me like 100% cats.”
Let’s look a bit deeper to see how HITECH […]
Will HITECH Lead to Innovation? The Continuing Cat/Dog Dialogue
Will the recently passed HITECH legislation — the federal stimulus funding for health IT — encourage innovation? or will it lock in outdated electronic health record (EHR) technology?
It’s a mixed bag — HITECH legislation is both dog-like (innovative) and catlike (protecting incumbents).  I’ll refresh your memory below on more specific definitions of cats and dogs.
Among many other reasons, HITECH is dog-like primarily because it has ended the question of WHETHER the U.S. is really serious about health IT reform. HITECH spells out […]
HITECH Overlap: Medical Home, Telehealth, Health IT/Exchange
What’s the commonality among Medical Home, Telehealth, and Health IT/Information Exchange initiatives?
They all relate to care coordination. As shown in the diagram below from the Kansas Health Policy Authority (KHPA), there’s a lot of overlap.
A larger copy of the slide is available in this March 2 PowerPoint presentation by Marcia Neilsen , Executive Director, KHPA.
What are some of the implications?
Why Clinical Groupware May Be the Next Big Thing in Health IT
by David C. Kibbe MD, MBA
What would you call health care software that:
Is Web-based and networkable, therefore highly scalable and inexpensive to purchase and use;
Provides a ‘unified view’ of a patient from multiple sources of data and information;
Is designed to be used interactively – by providers and patients alike – to coordinate care and create continuity;
Offers evidence-based guidance and coaching, personalized by access to a person’s health data as it changes;
Collects, for analysis and reporting, quality and performance measures as […]
New NRC Report Finds “Health Care IT Chasm,” Seeks New Course Toward Quality Improvement and Cost Savings
by David C. Kibbe, MD MBA
Like the Institute of Medicine’s (IOM) 2001 counterpart report, "Crossing the Quality Chasm," a new report from the National Research Council of the National Academies is complex, full of new ideas assembled from multiple disciplines, and is likely to have seminal importance in framing public policy from now on . "Computational Technology for Effective Health Care:Â Immediate Steps and Strategic Directions " […]
An Open Letter to the Obama Health Team on Health IT Spending
By David C. Kibbe, MD MBA and Brian Klepper, PhD
It seems likely that the Obama administration and Congress will spend a significant amount on health IT by attaching it as a first-order priority to the fiscal stimulus package. We take the President-elect at his word when he recently said:
"…we must also ensure that our hospitals are connected to each other through the Internet. That is why the economic recovery plan I’m proposing will help […]