National health IT coordinator Dr. David Blumenthal isn't allowed to say what the final rules for meaningful use of EMRs will look like until HHS releases its formal proposal, but every time he gives a speech, he drops a new hint or two about what he's thinking. Monday in San Francisco, Blumenthal largely gave attendees at the American Medical Informatics Association's annual symposium what they wanted to hear by reiterating his philosophy that technology simply is an enabler of quality improvement, not a panacea for healthcare.
"The meaningful use framework will be about the goals of care, not the technology," Blumenthal said. While he didn't elaborate on that statement, he did state the position of the Obama administration--one largely held by the informatics community, if not the broaded healthcare industry--that the billions of dollars in federal subsidies aren't simply meant to buy EMRs for providers. "It's not the money that will turn out to be the most important," Blumenthal said.
Instead, the net $19 billion investment is a way to demonstrate that EMRs should and will be accepted in the fairly near future as "symbolic of professionalism in medicine," just as much as the stethoscope or examination table are today. "The idea that government should subsidize health IT will be as foreign an idea that the government should buy stethoscopes or exam tables for doctors," Blumenthal explained.
"Information is really the lifeblood of medicine," Blumenthal added. "Health information technology is its circulatory system."
During the Q&A portion of the session, legendary medical informaticist Dr. Clement McDonald, the longtime director of the Regenstrief Institute for Health Care in Indianapolis and now the head of the Lister Hill National Center for Biomedical Communications of the National Library of Medicine, questioned this analogy. McDonald said HHS should approach health IT the way the Environmental Protection Agency regulates water quality. "Put a little onus on the polluters," McDonald said, referring to providers of "dirty" data that's useless. He drew a small round of applause.