Web Exclusive

A Turnaround Strategy for HIT
By Elizabeth S. Roop

According to C. Peter Waegemann, a nationally recognized HIT thought leader and advocate, a proper analysis of meaningful use’s (MU) impact on the health care industry requires a look back over decades of HIT failures. “The last 30 years had a series of IT failures,” he says. “The vision of electronic health records has strayed off course, and the expected benefits of information technology have not been realized to this day. In 1991, HIT experts believed that computer-based patient record systems would be fully implemented within 10 years. It didn’t happen. Then, in 1994, President Clinton announced that EHR systems would be implemented within a decade. This also didn’t happen. And in 2004, President Bush announced a new program to implement EHR systems by 2014, hereby creating the Office of the National Coordinator for Health Information Technology to ensure its success.”

Waegemann identifies four strategic periods of HIT development: computerizing the medical record, creating a level of interoperability through community health information networks, supporting and implementing regional health information organizations, and encouraging computer use through incentives by requiring consensus-based MU functionalities.

“I would rate the first of these strategies a mixed success, and strategies two and three were more or less complete failures,” he says. “Indeed, compared to these strategies, MU has done pretty well, despite its shortcomings.”

Waegemann says a significant roadblock to realizing MU’s potential is the protection it provides to established vendors, including a “defensive” and cumbersome certification process, regulations that favor established vendors and stifle innovation, and a failure to demand true interoperability and better communication systems.

Health care must reinvent itself through a “completely new strategy to achieve interoperability, greater efficiencies, and better e-care systems, involving all stakeholders in order to integrate health care into the digital society,” he says.

Waegemann proposes an approach to interoperability that overrides current obstacles and loosens or discontinues certification. He also would like to see a reexamination of privacy and data protection issues in which “HIPAA has been ‘hijacked’ by lawyers and others,” for example, by encouraging the use of and reimbursement for digital communication services.

Finally, he says, new technological solutions must be enabled by departing “from the dominance of the current message standards organization so that health care can move toward an open 21st-century approach. It is past time for the health care field to join the rest of our society in adopting and facilitating digital functionalities in order to improve care and reduce costs.”

— Elizabeth S. Roop is a Tampa, Florida-based freelance writer specializing in health care and HIT.