The nation's healthcare IT chief, David Blumenthal, MD, acknowledged that achieving meaningful use of health IT would be hard work, and then told his audience of more than 600 health system and hospital CIOs and IT managers there would be even harder work ahead.
"I know this is a big lift," he told them Wednesday in his keynote talk at the CHIME10 Fall CIO Forum. "We know that you have your hands full dealing with meaningful use," he added. "We can't stand still while the clock ticks. We are going to look into the future. We need to think about what meaningful use will look like in the later stages."
Bill McQuaid, CIO at Parkview Adventist Medical Center, says he's ready for more heavy lifting. Parkview, a 55-bed community hospital in Brunswick, Maine, is in tune with the privacy goals Blumenthal talked about later in his keynote. All Parkview laptops are encrypted. Parkview is ready to share data and thanks to physician champion Larry Losey, MD, physicians are on board with technology, too, increasing CPOE uptake from 51 percent to 78 percent over three months.
"The vision we had five years ago will be everyone's," McQuaid said.
In his talk, Blumenthal stressed data sharing and the critical need for privacy and security.
"We can never forget that as we get deeper and deeper in our work that the American people are watching," Blumenthal said. "Making them confident in our work is an ingredient to success."
On healthcare information exchange, Blumenthal said, "What we most want from the states is leadership to make sure that in every part of the country there is an opportunity for exchange." Those exchanges must be across organizational boundaries, geographic boundaries and competitive boundaries, he added. He envisions a future in which information follows patients across all those boundaries.
"One thing keeps sticking in my brain - the patient's data following them around," Erwin Rauschendorfer, CIO at Wayne State University School of Medicine in Detroit, said after the talk.
"Ultimately we need some kind of health ID number," Rauschendorfer said.
Gil Sullivan, workforce management evangelist for Chelmsford, Mass.-based Kronos, also focused on the part of Blumenthal's talk that raised issues about data exchange, privacy and security, patient consent and who would control the record. "Why not me the patient?" Sullivan asked. "I want to have more control."
Blumenthal said there had not been sufficient discussion and guidance about what patients would control nor what health information exchange needs to make it successful.
"We have a big complicated, ambitious problem to solve," Blumenthal said. "We will need robust discussion." The discussion, he said, would likely be loud and perhaps contentious, but it must be taken on.
Blumenthal said he expected the concerns attending the exchange of information, including privacy and security issues, would be "fully and completely considered in six to eight months."
Richard Shirey, CIO of Baptist Health System in Birmingham, Ala., says he has a full appreciation of the difficulties attending health information exchange. He is StateNet Coordinator in Alabama, one of 50 in a network of state CIO coordinators designated by CHIME, to collect and share information about HIE development in their states.
"It's a very difficult situation," he said. "It's important to understand what the states are going to do."
What struck Bill Shickolovich, CIO at Tufts Medial Center in Boston, was Blumenthal's take on the role of government when he talked about the 62 Regional Extension Centers created and funded by the government to help solo, small physician practices and critical access hospitals across the country that serve rural communities adopt and use electronic health records.
"I'm interested in leadership, and how they frame their views," Shickolovich said. He liked what he heard.
"It is the role of government to help the most vulnerable," Blumenthal said as he described the REC program.
Picking up another note, Blumenthal told the audience that change would be inevitable.
"I think we are on a course that is irreversible," he said. "Our job is not to wait for a generation to change. You will drive this in the future. It's years, not decades, away."
