Electronic Health Reporter

Fortuneteller Farzad Mostashari said recently that a lull in adoption of EHRs is expected, by him, and that 2014 will be a huge – banner – year for the adoption of the technology to participate in the meaningful use program, since 2014 is the last year to participate and still be eligible for federal incentives.

The penalty phase begins in 2015.

The incentive program is having a clear impact on adoption of the technology, as we all know. Without the “free” federal money and the threat of cuts in reimbursements, motivation to implement the oft described as burdensome technology was lagging.

According to Health Affairs articles –which Mostashari had a hand in writing – the uptick by physicians and hospitals since the HITECH Act created the meaningful use program, there are several long-known facts about health IT adoption:

•As mentioned above, federal incentives are motivating doctors to adopt EHRs, but rates of adoption in rural areas lag far behind those in urban areas. (Not surprising.)

•EHR adoption among hospitals is rapidly growing, but half of hospitals still had less than a basic system in 2012.

•Despite growth in health information exchange organizations, concerns persist about their long-term sustainability.

According to other reports, as detailed by Bloomberg BNA, “Among key findings in the report on hospitals, titled ‘Adoption of Electronic Health Records Grows Rapidly, but Fewer than Half of U.S. Hospitals Had at Least a Basic System in 2012,’ was that while hospital adoption of EHRs was at its highest ever, fewer than half could meet Stage 1 meaningful use criteria and just 5 percent could meet Stage 2 criteria. Researchers for the study concluded that ‘special efforts’ were needed to help “trailing” institutions catch up.”

Let’s continue: A Robert Wood Johnson Foundation report released July 8 in conjunction with the Health Affairs articles similarly found that federal incentive programs have driven the widespread adoption of health information technologies over the past three years, but that providers and hospitals continue to struggle with advanced uses of the technology.

Mostashari said participation numbers from the first phase of the meaningful use program indicated progress in nationwide health IT adoption, but that much work was ahead for the health care industry to achieve the goal of the incentive programs — improved health care quality.

Finally, we’re getting to the heart of the issue: Improved outcomes for patients, individuals as well as a population.

But rather than continue to focus on what Mostashari feels is the most important issue – total pervasive adoption of the technology – rather than begin to focus on some of the programs others goals; in this example, better patient care.

I have yet to see the ONC produce actual proof that patient care and outcomes are improving because of the adoption of the technology because of all its work. Instead, I hear nothing but how more and more adoption of the technology is needed. Even though requirements don’t begin until 2014 for physicians to show meaningful results, shouldn’t we begin to hear some anecdotes now?

Instead, all we seem to get is more talk – talk about big plans and happy, healthy people who are engaged in their care – even though the current situation seems to stand in complete opposition of this approach.

Any politician, as Mostashari is, clearly knows it’s best to lead with results before the results are required.

According to Mostashari, Stage 1 laid the groundwork for digitization of healthcare and Stage 2 of the program will push physicians and hospitals to increasingly use the data to shape care delivery.

Mostashari just does what politicians do when campaigning – shift the focus from one issue to the next. Instead of demanding to see results, he moves the conversation in another direction, to a lack of interoperability of EHRs.

Again, according to the Bloomberg, “Mostashari said proprietary data standards have persisted among health IT developers but that the industry is coming together to develop single standards for packaging patient data and securely exchanging that information.”

Apparently, when a problem exists one should not look within but rather should point fingers out. The problem clearly must be the vendors, who are not making products that speak with each other, shame on them.

Competitors –who have fought for deals in the trenches for years in the spirit of capitalism – should suddenly hold hands and swing their partners round and round. But I jest …

Perhaps federal money (incentives) could solve this problem, or the ever entertaining standard throw away from our leaders in Washington: cultural change is needed for institutions to see their competitors as partners for data sharing.