(Continued from Part 1) So the rules have changed and now we’re expected to document differently. But wait, there’s more. It’s not just recording more results; it’s driving better care and improving patient outcomes. It’s about participating in all these new programs we keep hearing about. What does that look like and who’s counting? On top of all this, it’s also goodbye fee-for-service and hello pay-for-performance. Performance implies standards, right? What standards? That’s where the evidence base of medicine comes in.
So, we’re improving patient outcomes, measuring those improvements and getting paid only if standards of improvement are achieved, right? To make matters even more interesting, this new game must be played out not on Eye Care Island but at Connected Care Central. Episodal care is losing significance. Continuity of care spans both time and the multiplicity of Eligible Providers who comprise the patient’s care team.
Back to EHRs. We can begin to see why traditional EMRs won’t stand the test of time. Recording results electronically versus on paper is not a big enough step forward to make the difference. It’s like moving from a mechanical cash register to an electric one when we really need barcode scanners and RFIDs. We can change what we call them (from EMRs to EHRs) but if the new name amounts to new lipstick on the old pig, the old pig will nevertheless die.
EHRs that survive the long road to Meaningful Use will be those built specifically for health care reform, created with capabilities beyond recording results. In particular, we believe, the lines will be drawn over Clinical Decision Support. In stage 1, we’ve seen the topic introduced at a base level (structured data). In stages 2 and 3, this area will take off. It’s at that point we’ll see more dropouts from the health care reform game and the hares will be separated from the turtles.
Alistair Jackson, M.Ed.
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