Government // Leadership
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11/19/2009
11:57 AM
Mitch Wagner
Mitch Wagner
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Blumenthal: Patient Care, Not Tech, Will Drive Meaningful Use

National health IT coordinator Dr. David Blumenthal dropped a big hint about upcoming criteria for giving out e-health records grants. He advised healthcare IT managers to focus on "goals of care" rather than technology.

National health IT coordinator Dr. David Blumenthal dropped a big hint about upcoming criteria for giving out e-health records grants. He advised healthcare IT managers to focus on "goals of care" rather than technology.Blumenthal works for the U.S. Department of Health and Human Services, which is responsible for giving out grant money to reimburse healthcare providers for implementing electronic medical records. The U.S. American Recovery and Reinvestment Act of 2009 (ARRA), which set aside the money, specified that the funding will go to "meaningful use" of EMRs, but did not specify a definition for the phrase. HHS plans to release a preliminary definition of meaningful use next month. But Blumenthal dropped a hint at an address at the Medical Informatics Association's annual symposium. He "gave attendees what they wanted to hear by reiterating his philosophy that technology simply is an enabler of quality improvement, not a panacea for healthcare," according to FierceEMR.

"The meaningful use framework will be about the goals of care, not the technology," Blumenthal said. While he didn't elaborate on that statement, he did state the position of the Obama administration--one largely held by the informatics community, if not the broader healthcare industry--that the billions of dollars in federal subsidies aren't simply meant to buy EMRs for providers. "It's not the money that will turn out to be the most important," Blumenthal said.

Instead, the net $19 billion investment is a way to demonstrate that EMRs should and will be accepted in the fairly near future as "symbolic of professionalism in medicine," just as much as the stethoscope or examination table are today. "The idea that government should subsidize health IT will be as foreign an idea that the government should buy stethoscopes or exam tables for doctors," Blumenthal explained.

"Information is really the lifeblood of medicine," Blumenthal added. "Health information technology is its circulatory system."

Final standards for meaningful use will be released in the spring, after a period of public comment on the first effort to be released by the end of the year, according to a ModernHealthcare.com write-up of Blumenthal's address.

Blumenthal stressed that health IT must be focused on the goal of making the healthcare system work better for patients and providers.

"It's not the technology that's important, but its effect," Blumenthal said. "That's the purpose of the stimulus bill."....

While Blumenthal declined to give a specific definition of meaningful use, he offered some hints. People working in health IT should think about EHRs "not as a technology project, but as a change-management project," he said. Components of meaningful use include sociology, psychology, behavior change and the "mobilization of levers to change complex systems and improve their performance," he added.

Through the stimulus law, Congress mandated that meaningful use become more focused over time, with yearly benchmarks. There has been a "lively discussion" in the Obama administration of that timetable in the proposed rulemaking of meaningful use, Blumenthal said.

Privacy and security will be essential, he said.

HHS plans to announce the first round of recipients of two major rounds of grants soon, Blumenthal said. The first, for $700 million, will establish up to 70 health IT regional extension centers nationwide to help healthcare providers become meaningful users of EHRs. The second program offers $560 million in grants to states to develop health information exchanges linking providers.

HHS also plans programs to increase the supply of trained health IT workers.

"The skills needed are not necessarily what our teenage children have," Blumenthal said, which brought laughter from the crowd.

Specifically, the nation needs professionals who understand meaningful use and improved processes of care, the ability to redesign workplaces to integrate the new technology and to help providers use the technology to its full potential, he said.

"The training needed is well beyond the installation of information technology," he said.

Blumenthal expressed great confidence that health IT can be a foundation for fundamental change in the healthcare system.

"I believe it will be a short time before EHRs are as common in medicine as the stethoscope, the cardiogram, the MRI and other core tools," he said. "I think we're already moving in that direction."



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