Sunday, December 9, 2007

Health Information Technology in Massachusetts Forum

Health Information Technology in Massachusetts: Private/Public Partnership? What Should the State's Role Be in Facilitating HIT Adoption?"

I recently attended this forum held in downtown Boston last week. The purpose of the form was to discuss the states role in health information technology adoption. There was an impressive panel made up of the top Healthcare IT leaders of the state, who also happen to be leaders at the national level as well. This panel included John Glaser, Ph.D; John Halamka, MD, Micky Tripathi and Janet Marchibroda.

The full list of speakers included: Secretary JudyAnn Bigby, MD; David Blumenthal, MD; Ray Campbell, Chris Gabrieli; John Glaser, Ph.D; John Halamka, MD; Jay Himmelstein, MD; Phil Johnston; Janet Marchibroda; John McDonough; Sen. Richard Moore; James Roosevelt, Jr.; and Micky Tripathi.

Here are some points made by the speakers at the forum which I found relevant:

Chris Gabrieli, Chairman of the Board Massachusetts Health Data Consortium
Chris worked for an EMR company in 1981 as part of a pilot. This system actually had decision support and clinical alerting. However when the pilot was completed, the medical clinic did not want to pay to have the system. As a result, the EMR equipment taken out of the clinic and the project was scrapped.

He spoke about the importance of patients being able to have a seamless transition when moving between healthcare providers. He compared it to how we can switch seamlessly from one cell phone provider to another while maintaining the same phone number.

John Glaser, Ph.D, CIO Partners HealthCare
Spoke about the need to broadly adopt healthcare IT technology.

The digital divide that is developing between the large hospitals/physician groups and the smaller healthcare organizations.

Partners Healthcare’s Telehealth programs and the benefits realized in managing CHF patients.

The need to get healthcare data exchanges up-and-running by aligning financial incentives between organizations.

Mentioned that MA-SHARE has gone as far as it can go and that now it needs broader support

Mickey Tripathi, CEO Mass eHealth Collaborative

EMR is a seen as a pure cost currently. The actual return on investment is seen much later.

Benefits of an EMR play out in a complicated manner over time. This is the reason why it's hard to establish a return on investment for EMRs using conventional methodologies.

John Halamka MD, CIO CareGroup Health System, and Dean for Technology at Harvard Medical School, CEO MA-SHARE

Spoke about the difficulties faced in trying save waste from the healthcare system by eliminating redundancy: "One man's redundancy is another man's country club".

Spoke of the problems of sustainability for RHIOs. He talked about how health-care providers will not pay if there is no infrastructure. In other words healthcare providers do not see the health information exchange as an investment. The challenge is how to build the infrastructure without the capital. John implied that the providers would see value and pay if there is a live health information exchange.

Janet Marchibroda MBA , Chief Executive Officer of the eHealth Initiative
The greatest challenge to RHIOs is building sustainability.
She mentioned that based on a recent survey on health information exchanges, the largest source of revenue is now coming from hospitals, not government grants.

The health information exchanges that are operational are exchanging Lab data, emergency department and outpatient clinical summaries.

Byron Byfield has written about the event on his blog.

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