To demonstrate meaningful use of electronic health records and thus qualify for incentive payments under the American Recovery and Reinvestment Act of 2009 (ARRA), healthcare organizations will have to invest in health information exchange (HIE) technologies. David Blumenthal, M.D., National Coordinator for Health Information Technology, has made it very clear that information should follow the patient "across the enterprise and among competing entities."  The HIE market is characterized by a number of suppliers offering a wide variety of technologies and strategies to exchange health information including integration platforms, data aggregation, physician portals, and composite applications. There is a not a one-size-fits-all solution.

Last week most of our healthcare team, including me, Lynne Dunbrack and Janice Young, headed to Atlanta for the HIMSS 2010 event.  The change in energy at the event from 2009 was apparent from the moment we arrived.  While the atmosphere at HIMSS 2009 was laced with cautious optimism as providers examined the HIT provisions of the recently-published American Recovery and Reinvestment Act, it was clear in the first hours of HIMSS 2010 that the pace had shifted and action and investment were underway. 

Achieving “meaningful use” is the new holy grail in the realm of electronic medical records (EMRs) and electronic health records (EHRs).   The HIT Policy Committee convened last Friday to hear from the various workgroups and receive an update from the HIT Standards Committee.   The Meaningful Use Workgroup did not recommend any changes to the second draft of its Meaningful Use Matrix, which was presented at the last HIT Policy Committee meeting on July 16, 2009.  The Workgroup did present a timeline for its activities over the next 12 months. Notable among the activities is that an assessment of the industry’s preparedness for meeting the 2011 objectives will not take place until Q410.  It would seem, especially when one considers the low adoption rates of EMRs, EHRs, computerized physician order entry (CPOE), and health information exchange (HIE) technologies, that such an evaluation should have taken place before the Meaningful Use Matrix was developed.  A case in point is the aggressive timeline for 100% use of CPOE.

On June 16, 2009, the Health IT Policy Committee published a draft description of the definition of meaningful use of EMRs by provider organizations.  The published materials included a presentation, a preamble document, and a matrix summarizing the priorities, goals, objectives and measures for meaningful use.  Health Industry Insights expects to provide analysis in this community forum in the upcoming days, with more to come in our reports and publications.  The deadline for public comments on the definition to the Health IT Policy Committee is June 26, 2009.

EMR applications automate vast amounts of mission-critical functionality in the provider setting.  With over 100 vendors to choose from and looming deadlines for implementation and demonstrating meaningful use to receive stimulus payments, inpatient and ambulatory facilities are faced with difficult decisions.  For this reason, Health Industry Insights is beginning its 2^nd annual EMR/EHR Short List research program.  The Short List is designed to offer providers selection tools that differentiate vendor-supplied EMRs on the basis of customizable characteristics that are critical to their organizations.  In order to create the Short Lists, I have been speaking with providers in the trenches in order to present the hard facts on their EMR decisions, the day-to-day issues they face and the best practices they're using. 

On Tuesday, February 17, 2009, President Obama signed into law the $787 billion American Recovery and Reinvestment Act of 2009 (ARRA), which provides about $20 billion in funding for healthcare IT, including incentive payments to physicians who implement and use eligible electronic medical records under the conditions laid out in the law.   The payments are conditional upon implementing an "eligible" product, and demonstrating "meaningful use" of EMRs.  However, the definition of meaningful use provided in the bill is far from specific, and many questions remain to be answered.  Last week, the Department of Health and Human Services announced it will offer guidelines on meaningful use for hospitals and practices.

Healthcare IT (HIT) terminology is confusing, even for experts as numerous similar and confusing terms are used to describe instances of HIT. The terms electronic health record (EHR) and electronic medical record (EMR) are commonly used interchangeably, but they are not synonymous.

In a recent report, Health Industry Insights (HII) established the definitions of these terms that we will use in our research, and compared these definitions with those of other respected industry sources including those published in April 2008 by the U.S. Department of Health and Human Services (DHHS)'s Office of the National Coordinator for Health IT (ONCHIT). Our definitions emphasize the similarities in their solution components, while differentiating them on the basis of their interaction with other entities in the surrounding health IT environment.