Last week’s landmark decision from the Supreme Court clears the way for full implementation of the 906-page healthcare reform law. Know anyone that read it from cover to cover? I didn’t think so. No worries – basically, the law establishes insurance exchanges in each state, prohibits insurance companies from discriminating against the sick, and requires nearly all Americans to prove that they carry health insurance starting in 2014.
John W. Loonsk MD, the CMO at CGI Federal, recently wrote an excellent piece about this decision and how it may impact health IT – After SCOTUS decision, health IT orthodoxy worth rethinking. Dr. Loonsk makes several key observations, but one in particular caught my attention. He wrote:
“[W]hy not change the orthodoxy that has the country only funding increasingly complex EHRs? Alternatively, we could orient the funding more to the digital data themselves. The latter could establish an ecosystem around high-quality, standardized data in exchangeable summary records, problem lists and care plans, etc. with whatever software was needed to get to them.”
I couldn’t agree more with these insights. After all, it’s the data that the government is after, right? Why not orient the funding toward the actual digital data? Doctors don’t get more money because they’re able to master a particularly complex EHR. They get money for providing data through standardized digital means to the government. Why not make it easier on a group of people that is already struggling to make ends meet?
What’s really interesting is what Dr. Loonsk goes on to say:
“And if we can focus on the data more, perhaps we can focus on the EHR software less. And if we focus less on the EHRs perhaps we can focus more on broader health IT systems and population health outcomes that are the more fundamental connection with health reform.”
If a practicing physician’s focus is diverted from providing good care by the challenge of inputting the correct data into her needlessly complex EHR, health IT providers have failed the providers. The EHR should be invisible, or at least unobtrusive, to the doctor and their staff and the data submission a simple extension of the valuable charting and communicating with patients that is really the role of an EHR. The focus should shift to creating data-accessible EHRs that practitioners can learn quickly, navigate fluently and begin to use for much more than simply Meaningful Use submissions. A compelling user-experience should be as important as data integrity when designing such systems.
So what does the latest SCOTUS ruling mean for you, the independent primary care doctor who’s seeing 25 patients a day, employing 4 staff and busily trying to make sure you get your HITECH dollars by meeting the Meaningful Use criteria?
First, as I’m sure you’ve heard, there’s a good chance you’ll see a bolus of new patients wanting to join your practice. Second, as we move down the road to accountable care for your entire patient population, it means that you’re going to need ways of managing and engaging this growing panel while maintaining high levels of care and a profitable practice.
So how do you achieve these diverse goals? Well, start by challenging the orthodoxy of EHRs by finding a system that helps you manage and leverage your data effectively for the good of your practice, not simply the government. Once you’ve found that tool, ask yourself – will this help me provide better care AND thrive in my practice? If the answer to both is YES, then you’re on your way, my friend.