(2009-04-09) Blumenthal Stimulating Emr Use

David Blumenthal wrote about stimulating EMR use in the New England Journal Of Medicine. Second, much will depend on the federal government's skill in defining two critical terms: "certified EHR" and "meaningful use." (Certified [[EMR]], Meaningful Use Of EMR) ONCHIT (NCHIT) currently contracts with a private organization, the Certification Commission for Health Information Technology (CCHIT), to certify EHRs as having the basic capabilities the federal government believes they need. But many certified EHRs are neither user-friendly nor designed to meet HITECH's ambitious goal of improving quality and efficiency in the health care system. Tightening the certification process is a critical early challenge for ONCHIT. Similarly, if EHRs are to catalyze quality improvement and cost control, physicians and hospitals will have to use them effectively. That means taking advantage of embedded clinical Decision Support-s that help physicians take better care of their patients. By tying Medicare and Medicaid financial incentives to "meaningful use," Congress has given the administration an important tool for motivating providers to take full advantage of EHRs, but if the requirements are set too high, many physicians and hospitals may rebel - petitioning Congress to change the law or just resigning themselves to forgoing incentives and accepting penalties. Finally, realizing the full potential of HIT depends in no small measure on changing the health care system's overall payment incentives so that providers benefit from improving the quality and efficiency of the services they provide. Only then will they be motivated to take full advantage of the power of EHRs.

Apr21 update: Jacob Goldstein (Wall St Journal) on the challenges Blumenthal faces. The stimulus bill (ARRA) says doctors and hospitals must use "certified" electronic systems (Certified [[EMR]]) to qualify for incentive payments, but the job of establishing certification criteria will fall largely to Dr. Blumenthal, named to the post from Harvard Medical School last month... The stimulus legislation doesn't specify whether CCHIT should be the group to certify electronic-records systems, but Dr. Leavitt says the group is open to modifying its certification requirements. Dr. Blumenthal wouldn't comment on whether CCHIT will remain the key group for certification.