‘Meaningful use’ toward HIEs – questions for Dr David Blumenthal

I read with interest update 3 by Dr David Blumenthal of the Department of Health and Human Services.

Firstly Dr Blumenthal, consistently uses the term EHR (Electronic Health Record).  Per my definition of EHR vs EMR (Electronic Medical Record) an EMR is used by one vendor such as a physician, whereas an EHR is a patient’s collective record of medical data sourced by several healthcare providers.

Questions for Dr Blumenthal:

  1. Did you mean that health care providers should implement EMRs,  not EHRs?
  2. How will the various EMRs share data between each other (and their regional HIEs/RHIOs )  so that patients can move with ease from provider to provider? Will HITSP provide standards that EMRs can adhere to? Will HL7 be updated?
  3. What about medical terminology? Will EMR vendors adhere to LOINC or ICD-10 so that a universal EHR can be created for patients?

One thought on “‘Meaningful use’ toward HIEs – questions for Dr David Blumenthal

  1. Hi Jonathan,

    I pretty much seem to agree with your view point on the issue of using the right word. But apart from that I also wanted to add a few things to his advices on meaningful use and the HITECT act.

    I feel today medical practitioners are looking to avail of this federal incentive by trying to comply with the definition of meaningful use but at the same time EHR providers are looking at their own set of profits.
    This misunderstanding is mostly I believe as a result of wrong interpretation of the federal guidelines.. The EHR providers need to look at these guidelines from the prospective of the practitioners who deal with different specialties.
    Each specialty EHR has its own set of challenges or requirements which I believe is overlooked by in most EHR vendors in a effort to merely follows federal guidelines. This is resulting in low usability to the practitioners, thus less ROI, finally redundancy of the EHR solution in place.
    I think ROI is very important factor that should be duly considered when look achieve a ‘meaning use’ out of a EHR solution. Though one may get vendors providing ‘meaning use’ at a lower cost, their ROI / savings through the use of their EHR might be pretty low when compared to costlier initial investment. Found a pretty useful ROI tool that is pretty customizable and easy to use. It also accounts for the different specialty EHR’s too.

    Also the introduction of REC’s through the HITECH act. is a great way to avail of quality EHR solutions at competitive prices. The stiff competition among not only these REC’s but also among EHR vendors ( to become a preferred vendor of a given REC) will result in lot of positives to medical practioners.
    Looking the funding provided to the REC’s, the staggered grant allocation system also promises to be an unbiased way of allocating funds. It will also help in the concept of REC’s helping out each with their own unique business models. It can be one of the possible answers to the ‘safe EHR vendor’ challenge as discussed by many critics.

    Sorry to have diverted a bit from the topic but I feel this HITECT act and the REC’s are going to play an important role, as discussed above in the successful EHR implementation in the medical practices in our country.

    As far as implementation challenges goes, the federal guidelines for certification and usability are pretty much clear. Useful improvisation on these lines can make ones EHR’s friendly to most practices of varying specialties.

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