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Ask the Experts


From the impact of HITECH to the industry’s perception of healthcare IT, our panel of experts weighs in on some heavy issues:

The federal government’s role in health-

care IT continues to evolve; where do you see it heading after a couple years of HITECH implementations? Will a single, lead certifi - cation and standards entity emerge after the HITECH dust settles?

Daniel O’Donnell

There is some chance that the rapid infl ux of federal incentive money for HIT adoption, with short deadlines and unsettled changes in certifi cation processes, will temporarily add to the confusion and anxiety experienced by prospective adopters. These are very complex and expensive decisions that

T in H a p c p c

require skill sets that are not ordinarily part of the mix. It is telling that a concurrent federal initiative is designed to create training and advisory services, acknowledging that there are not enough skilled healthcare informaticists and technology specialists out there to make effi cient use of important fi nancial incentives.

i kill t

As with any large-scale initiative, there will be both anticipated and unanticipated consequences. An anticipated consequence will be that these initial efforts will not be adequate for widespread adoption and effective use to truly coordinate the care of the majority of complex patients. I suspect that an unanticipated consequence will be the need for signifi cant payment-system and medical-cultural changes. Technology currently available, but not yet widely used, is capable of enabling truly coordinated care. But time required for real coordination is not compensated, and medicine is not yet a team sport.

8 October 2010 Justin Barnes

I certainly see the roles of CMS and ONC as ongoing enterprises, as the administration of meaningful use continues through Stage 2 and Stage 3 criteria. Like the current Stage 1 requirements, further stages will need coordinated rulemaking and stimulus payouts.

I suspect that the HHS role will become more of aeo e of

stewardship as CMS and ONC oversee these stages of updates and maintenance which are already planned through the next decade. Throughout this process, it will remain important for private sector collaboration to remain intricate for the success of any of these programs, processes and policies. I agree with ONC’s vision that the private sector administers certification when the permanent certification process rolls out in the near future, although ONC will still have a hand in oversight and must provide necessary transparency to the transition and process. Ultimately, we’ll have to see what market forces prevail. I think I can safely predict that CCHIT will emerge as one of the fi rst, if not the fi rst, ONC- ATCB, which will bring some short- and long-term stabilization to the process.

Jonathan Teich

As the fi nal rule for meaningful use shows, the government is placing great emphasis on adoption of EHRs and on implementing basic capabilities that can expand in the future. The focus will move toward making use of EHRs for improved performance and outcomes, clinical decision support to

A s e o t fo E o

improve quality and safety, and analytics and reporting to measure it.


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