Several articles published in today’s New England Journal of Medicine are worthwhile reads (all of which, I believe, are free full text).

• News flash (not!): We have a long road ahead. A new study out of Harvard updates the dreary state of electronic health record (EHR) adoption by U.S. hospitals. Just 7.6% of surveyed hospitals have a basic system and a measly 1.5% have a comprehensive EHR system throughout the hospital.
• Incoming HHS National Coordinator for Health Information Technology David Blumenthal, MD, MPP, makes some important points about how the HIT provisions in the stimulus bill were designed to generate “improvements in health and health care” and not just increase EHR adoption. Aside from the financial incentives (and  down the road, penalties) for providers and the important infrastructure created, Blumenthal highlights the critical importance of the “federal government’s skill in defining two critical terms: ‘certified EHR’ and ‘meaningful use.’” He is right that tightening certification criteria and “motivating providers to take full advantage of EHRs” are prerequisites for HIT actually improving quality and efficiency. I’ve described this and the importance of stretching out “meaningful use” to meet the needs of consumers before.
• Paul Tang, MD (Palo Alto Medical Foundation), and Tom Lee, MD (Partners), have an excellent piece comparing the advantages of stand-alone personal health records (PHRs) with what they call “integrated PHRs.” The latter term describes electronic portals that allows patients to gain access to provider EHRs and, perhaps more importantly, communicate directly with their clinicians. One of the big question marks is how fast will the stand-alone version effectively integrate with clinician records to help support the kind of information-supported communication that facilitates participatory medicine.
• An interesting piece from Kenneth Mandl, MD, MPH, and Isaac S. Kohane, MD, PhD, from Children’s Hospital in Boston, makes the argument that HIT “components should be not only interoperable but also substitutable.” Thankfully, they describe in excellent detail the broad range of applications and examples that comprise those “components.” It’s an excellent list, though it could benefit from some more emphasis on content applications.

This entry was posted on Thursday, March 26th, 2009 at 12:55 pm and is filed under Data, EHRs, Inside the Beltway, PHRs, Participatory Medicine, Patient-Clinician Relationship. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.