During the first half of 2010, all eyes in the world of health information technology were focused on the forthcoming Stage 1 meaningful use requirements, the criteria that hospitals and eligible providers have to meet to receive federal reimbursement for the implementation of electronic health record (EHR) systems. The proposed rule for Stage 1 included a large number of requirements, and the U.S. Department of Health & Human Services (HHS) received more than 2,000 comments from health IT stakeholders across the country. The majority of health care CIOs were concerned they would not be able to meet Stage 1 requirements in time because of such problems as a workforce shortage and lack of vendor readiness. Despite all this angst about Stage 1, policymakers and health IT industry stakeholders continued to march forward with plans for Stage 2 meaningful use requirements, which are slated to roll out in 2013.
In July, HHS released the meaningful use final rule, with a smaller set of requirements for providers and hospitals. Though stakeholders were happy that some requirements had been reduced, many providers and hospitals were still concerned about the aggressive timeline for meeting them. In August a study showed that only 2% of hospitals were ready to meet the Stage 1 meaningful use requirements. Lawmakers have been trying to sweeten the deal by tweaking the HITECH Act legislation to get more incentive money for hospitals.
The health care organizations moving forward with an EHR implementation are eager for information on how to research, purchase and implement a system. Experts agree it’s important before purchasing the software to consult the nurses and clinicians who will use it. It’s also important to buy software that is certified and adheres to EHR standards for security, reliability and interoperability. In addition, providers must be aware of the legal ramifications of using an EHR system.
Another important tool is project planning, especially for large-scale EHR implementations. In October, the Department of Defense announced it planned to scrap its existing EHR system and build a new one, citing lack of project planning and ineffective requirements-gathering as major weaknesses that led to an incomplete system and the need to build a new one.
For many health care providers, finding the right EHR vendor can be a daunting challenge. Smaller providers are encouraged to contact their designated regional extension center (REC) for assistance. By July, a handful of RECs had picked preferred EHR vendors, but many could opt for an open program with no preferred vendors. EHR vendors are experiencing their own ups and downs: A report in September showed that many of the big vendors were seeing only limited growth, though Epic Systems appears to be doing quite well. Newt Gingrich helped to create a fanfare for GE Healthcare’s Centricity product, a Software-as-a-Service EHR system for ambulatory practices, while Microsoft’s hospital information system, Amalga HIS, died quietly.
Health care goes mobile in 2010
Another upward-trending topic this year was mobile health, or mHealth. Telehealth — one aspect of mHealth — has been gaining traction in the U.S., with the Department of Veterans Affairs leading the way by offering such services as virtual visits and remote patient monitoring (RPM) to its veterans. RPM technology could save the U.S. health care system billions of dollars if it’s used to manage patients with chronic diseases, the Center for Technology and Aging believes. This summer, the center awarded a $100,000 grant to fund a home telehealth demonstration project in New England that hopes to demonstrate the efficacy of RPM technology for managing chronic diseases.
Mobile devices such as smartphones and tablets are making a big splash in health care technology, especially since the release of the iPad earlier this year. The iPad adoption curve has been quite steep, with many physicians singing its praises. But there’s a lot of conflicting intelligence about the iPad’s prospects in health care, with some health care IT leaders hoping for an iPad alternative that plugs in and plays well with their present infrastructure.
And new mobile devices for health care indeed are coming out of the woodwork. Cisco Systems’ Cius, unveiled in June, has a strong focus on Web conferencing capabilities and runs on the Google Android operating system. Hewlett-Packard’s Slate, which targets the health care industry, is more rugged than the iPad, and has more sophisticated out-of-the-box multitasking. In September, Motorola unveiled its first enterprise digital assistant for health care. It’s not as sleek as the iPad, but it comes with a bar code scanner for bedside medications, and it can be sanitized easily.
With all these mobile devices coming into play, it’s no wonder the market for mobile health applications is exploding. It will be exciting to see what 2011 brings for the world of health IT.