The Tipping Point Problem

Thought leadership has its challenges, a big one being the tipping point problem.


In these early days of electronic communications between eye care and primary care, we're facing the same problem as the poor guy who had the first fax machine. Or the first phone. Who do you fax to? Who do you call? Or a more recent analogy, how about the first users of e-prescribing? How often did they (or you!) query a patient only to find no data? Today, it's rare to find an empty record.


In these scenarios and others like them, inventors, innovators and early adopters must look forward in anticipation of the tipping point, the day when an idea reaches critical mass. The electronic sharing of Protected Health Information is an idea whose time has not yet come. Is it a good idea? More than that, it's a fantastic idea! Are there detractors and obstacles. Yes, there are. Will we push past the barriers? Absolutely.


We've reached the tipping point on e-prescribing, wouldn't you agree? Despite some numbers out today* showing only 20% attestation in the ambulatory market, I believe we've reached critical mass on EHRs. (This percentage counts neither the hospitals nor the many providers who have adopted EHRs but not yet attested to MU.)


Remember, EHRs are not an end in themselves. It's not about legible exams; it's about sharing and communicating. Communications is the next step after EHRs, the qualifier to gain access to team-based care and bundled payments. In that game, we're at the early adopter phase. Most states and health systems are still thinking internal communications. Therefore, we're busy creating state HIEs, in many cases closed empires. That's not the end game either. We'll get to open systems and inter-state communications. For better or worse, people travel and need health care where they go, and families span the continent. That the part that the Office of the National Coordinator understands very well. And that's the reason for the Direct Project.


Interested to see how we're progressing toward the tipping point for DIRECT communications? Check out an interesting map here. And while you're looking, read up on the Direct Project.


Alistair Jackson, M.Ed.


* EMR and HIPAA, June 20 - Meaningful Use EHR Breakout by Percentage. Click here to read.