In case you aren’t in Healthcare IT and missed the news, this past week saw the final release of “meaningful use” standards in the United States. These are government goals for deployment of electronic health records in hospitals and physician practices, for over the next two years. The New England Journal of Medicine has a nice summary here.
There has been quite a bit of public discussion on those requirements, and a sense that the first few versions were fairly draconian and unattainable. The original 23-25 requirements have been reduced to a set of 15 core (non-discretionary) requirements and a set of 10 discretionary requirements, of which 5 can be chosen. And some of the thresholds for compliance were reduced.
From an outsider’s perspective (I was not part of any of the committees or processes – just a peanut gallery watcher), the discussion and final rules seem to be reasonable (albeit challenging for some institutions) and took into account many critics feedback. Bravo.
These measures are backed by Medicare/Medicaid incentive payments and reimbursement schedules that will reward organizations that comply.
This is not one of those headlines that the general public is tuned into (and often involves IT speak that only a healthcare geek could love). But it will have as wide ranging an impact on healthcare delivery in the U.S. as, say, the banking acts resulting from the depression had on our financial lives. This is big.
Let me pick on two that have a direct affect on the general population:
(REQUIRED) On request, at least 50% of patients requesting an electronic copy of their health information (diagnostic tests, problem and medication lists, and more) must get them within 3 days, and
(OPTIONAL) At least 10% of patients get electronic access to their information within 4 days of it being updated in the Electronic Health Record.
In previous blogs posts I’ve spoken about my lifetime metric of how providers respond to my request for a copy of my record. It has gone from “why would you want that” to (today) a mixture of paper and CD’s with images. Usually takes 15-30 days and some poor person in a back office sits in front of a copying machine to do it. In one case, the provider tried to convince me that I didn’t need it, and shouldn’t have it. I’ve also written about the stack of paper we would carry for our children’s records, as we moved around the country for employment reasons.
This is a milestone event, and we’ll look back at it as the start of when people started taking responsibility for their own healthcare; Call it the Quickenization of personal healthcare – coupled with consumer driven tools like Google’s and Microsoft’s.
Where is this going?
- Ease of use/access issues still need to be overcome – lest this be a dead end for most people that still dread the Windows “any” key.
- Individual incentives (not necessarily financial) need to make personal healthcare record tools a “killer app” for most people.
- We still need the holy grail of cross-organizational healthcare record sharing (through Health Information Exchanges).
- Some providers will be challenged in meeting these requirements; some will resist – just on cost impacts alone.
- The potential for innovation at the consumer level is enormous – software, tools, social networking, online access to healthcare information, and new gadgets; no question that handheld devices can/will play a big role.
- and, or course, privacy and security continue to be a challenge.
These rules are the basis for a patient/consumer centric phenomenon that is a 10.0 earthquake in the healthcare world. And within 5 years will be affecting most (if not all) U.S. healthcare consumers.
The U.S. healthcare system can play a leadership role in the merger of IT technology and healthcare – especially at the consumer level. Issues of healthcare cost and efficacy continue to be worked, but hospitals and practices (and IT) have their marching orders.
This, my friends, is the democratization and consumerization of healthcare.