Over the week several readers of my blog, eHealth Musings, have asked me to comment on eHealth Ontario’s recent decision to terminate its contract with CGI to build an electronic Diabetes Registry. Check out my article on this topic at Technology for Doctors.
Perhaps one of the Steve Jobs’ greatest legacies is the iPhone and the app ecosystem that it supports. Rather than trying to define and develop every bit of functionality that an iPhone has to offer, Apple handed the opportunity to do so to hundreds of other organizations, large and small. Apple gave up some control in exchange for unprecedented growth in market share and, ultimately, stock price. Imagine for a moment if a similar approach was applied to the design of EMRs and other eHealth applications. Might the same level of innovation and user adoption result? A team led by Harvard University seems to think so and was awarded $15M by the U.S. Office of the National Coordinator for Health IT to turn their ideas into reality.
You can read the rest of my monthly Technology for Doctors column here.
As the U.S engages in major effort to drive adoption and meaningful use of electronic health records, a shortage of Health IT professionals threatens to impede progress. Indeed, the U.S. Bureau of Labour Statistics predicts a possible shortage of approximately 50,000 qualified Health IT professionals.
To combat this problem, the American Health Information Management Association (AHIMA) has launched the HIT Pro™ exams which, according to AHIMA, are designed to “assess basic competency of individuals who are seeking to demonstrate proficiency in certain health IT workforce roles integral to the implementation and management of electronic health information.” These exams consist of 125 multiple choice questions and are expected to take three hours to complete.
The HIT Pro™ exams offer individuals who have taken a short-duration, non-degree health IT workforce development program or who have acquired relevant, on-the-job experience the means to demonstrate their health IT competency. At this time, exams have been developed for six distinct competency profiles:
- Clinician/Practitioner Consultant
- Implementation Manager
- Implementation Support Specialist
- Practice Workflow & Information Management Redesign Specialist
- Technical/Software Support Staff
For a limited time, there is no cost to U.S. citizens to write one of the HIT Pro™ exams. The cost is covered through funding from the U.S. Department of Health and Human Services (HHS). This program illustrates yet another way that the U.S. government is moving forward aggressively to deploy electronic health records across the continuum of care. When potential roadblocks such as a potential shortage of qualified Health IT professionals is identified, it seems that program is quickly developed to address the problem in the most practical way possible.
Regular readers of my blog and the articles that I write for several publications will know that I have considerable concerns about the usability of physician office health IT systems (typically referred to as EMR in Canada and EHR in the US). The US Office of the National Coordinator for Health IT (ONC) shares my concerns [or, perhaps, I share their concerns ] and has funded the US National Institute for Standards and Technology (NIST) to provide advice on how to improve the usability of EHR software.
According to a post on MedHealthWorld, NIST has released two publications related to EHR usability design and testing:
I am huge fan of user centered design. I have personally witnessed the level of user acceptance of the software produced using this approach. By actively engaging users throughout the design and development process, the likelihood of user acceptance is greatly increased. Indeed, I have seen users literally nagging developers as to when the software that they helped design would be ready for them to use.
Having announced the Stage 1 Meaningful Use rules this past summer, the U.S. Office of the National Coordinator for Health Information (known to most people as the ONC) did not wait long to start work on stage 2 and stage 3 Meaningful Use rules. Earlier today, David Lansky, Chair of the Quality Measures Workgroup, posted a request for comments on proposed new clinical quality measures. These measures were developed by five tiger teams, each focused on different measure domain:
- Patient and Family Engagement,
- Clinical Appropriateness/Efficiency,
- Care Coordination,
- Patient Safety, and
- Population and Public Health.
The resulting measures were reviewed and consolidated by the Quality Measures Workgroup which is now calling for public comment. In addition to general comments, the Quality Measures Workgroup also seeks specific examples of measure for each measure concept.
Comments will be accepted until December 23, 2010 [which, by the way, also happens to be my oldest son's birthday ]
According to a recent iHealthBeat article, Dr. David Blumenthal, the U.S. National Coordinator for Health IT, identified four barriers to health IT adoption in the US in a recent speech. These barriers include:
- A lack of adequate funds;
- Not having the necessary infrastructure to support the exchange of health information;
- Concerns among health care providers about what type of EHR system to purchase and whether it will become outdated; and
- The need to convince the general public that health information will be exchanged privately.
In the same speech, Dr. Blumenthal stated that many of these challenges will be full or partially addressed by the various initiatives driven by HITECH Act funding.
Does Canada face similar challenges to the US regarding adoption of health IT? Are our various funding programs (provincial EMR programs, Infoway programs, etc) addressing the Canadian challenges or are additional initiatives required?
A recent post on the ONC blog seeks input on their strategic goal to “Empower Consumers to Better Manage Their Health through Health IT”. Specifically, the ONC asks for input on two questions:
- First, do you agree with the four objectives listed below?
- Second, what specific activities would you like to see the federal government take on? See the bullet points below each objective for some starting ideas of possible activities.
The ONC’s strategic objectives for Consumer eHealth include:
- Objective A. Engage consumers in federal health IT policy and programs
- Objective B. Accelerate consumer access to electronic health information
- Objective C. Foster innovation in consumer health IT
- Objective D. Drive consumer-provider electronic communications