July 19, 2010

Tom Sullivan, M.D.

Will the HITECH journey produce jobs in America?

There has been considerable activity at the Federal level over the past week regarding new technology in general as well as EHRs and eRx in particular. It seems that not a month goes by where we are reminded of the press of innovative technology and how we must “catch up” with other countries that have invested in these technologies proportionally more than us over the past decade.
An illustrative example was chronicled early last week when President Obama visited Holland, Michigan to help celebrate the opening of a plant that will employ a few hundred people and will manufacture the sophisticated batteries needed to power the upcoming Electric Vehicles (EV) made in America such as the Chevy Volt, the electric Ford Focus and the Tesla cars among others. A $2.4 billion federal stimulus helped to jump start this journey to the future where the government and industry are betting serious money and strategic initiatives that the demand will be large and the industry will be sustainable and produce good jobs for at least the rest of this century.
So it is with the federal stimulus for EHRs, eRx and Clinical IT in general, though our stimulus amounts to at least 10 times more than the battery money. In a parallel fashion, both the federal government and industry and making some big monetary bets that this “HITECH” journey will produce good jobs in America and see enduring demand for the products and services long after this generation is gone.
The need to teach and train a new generation of professionals to support the networking and other technologies that require more security than commercial IT as well as wider understanding of the complexity of various clinical workflows are major examples of the job skills that are in demand and will increase dramatically once clinicians start adopting these tools in greater numbers. In addition to the professional caregivers, both patients and their families will need to learn more about the IT options to communicate with their doctors and with the complex health system we have created in this country.
Several examples were published last week on July 13th by CMS and the Office of the National Coordinator (ONC). “Final Rules” were released on that day that address both how Meaningful Use (MU) and the IT Standards will play out over 2011 and 2012 (Stage I) which are the first two years where the $44 – 64k reimbursement will start to be distributed to clinicians.
In general, the final rules were made much easier for the major stakeholders and their efforts to qualify for the reimbursements; this was the direct results of considerable feedback during the comment period as well as numerous instances of outreach to clinicians and to industry on the part of David Blumenthal, MD and his staff from ONC.
eRx continues to be the clearest use case for clinical IT that gives the most rapid and reliable “Return on Investment” (ROI) for most physicians and prescribers. However, the day in nearing where many practitioners, especially in large groups, will find it compelling to add functions to the eRx application or to make the jump to the full suite of functions in a robust EHR. DrFirst has been planning for this migration for several years and offers products and services to cover the spectrum of health care providers.
References to the details of the publication of the Final Rules for both Standards and Meaningful use are linked below:
From The New England Journal of Medicine (Always the best!!):
From John Halamka, MD’s blog (always informative) – The Geek Doctor – This past week he has summarized the Standards as well as the MU rule and offered his comments and  links to the pdfs of the Federal Register official publication:

About Tom Sullivan, M.D.

Thomas E. Sullivan, M.D is a board-certified specialist in cardiology and internal medicine with over 40 years of clinical practice. He currently works for DrFirst and sees patients part-time in Massachusetts. His expertise in the application of information technology to health care has helped to create an international standard (ASTM) for the exchange of medical record information called the Continuity of Care Record (CCR). With AMA, he was founding chair of their e-Medicine Advisory Committee, worked with the Physician Consortium for Performance Improvement, represented the AMA and helped create the Physician EHR Coalition and is past chair of the AMA Council on Medical Service.