Clarion call for EHR change hard to ignore

It's not often that the week's EHR news, appearing to be about different topics, really are variations of the same theme.

Just look.

Interoperability: There's the warning from the Brookings Institution that the government was caught off guard by EHR vendors' reluctance to embrace data sharing, that the vendors now are holding the data "hostage" for hefty fees, and to resolve the problem the government should stop paying the ransom. Now's the time to let market forces take over and make the vendors lower their prices.

EHR adoption: Then we have the results of a new survey reported in the Annals of Internal Medicine that found that 9 percent of doctors have "unique" challenges that are keeping them from adopting EHRs, that this will have a broad impact on healthcare delivery as a whole, and that they'll need "extensive" support to implement these systems. Now's the time to help them.

Patient safety: Then there's the editorial in BMJ Quality and Safety lamenting the slow progress that the industry has made in using EHRs to improve patient safety, but saying that we should not "lose hope" or be "pessimistic" about it. Now's the time to fix it.

Utilization management: There's also the report of a new study that found merely tweaking EHR menus can have a significant impact on lab test orders and patient care. Now's the time to customize EHRs to improve utilization.

The future of health IT: And last but not least, the many comments on ONC"s draft strategic plan, recommending a host of suggestions, including better data security, inclusion of more types of providers, more patient control over their records and the like. Now's the time to reassess our direction, including ONC's involvement.

It's all about the need for change--now.

Now, there are always calls for change in the world of EHRs. People clamor for changes in the Meaningful Use program, the platform for interoperability, the effectiveness of health information exchanges and EHR usability. This is an area of intense scrutiny. Case in point, the Health Affairs Blog post this week penned by five U.S. senators who in 2013 called for a reboot of the program; they want to know where HITECH's $35 billion investment is going.

And that's understandable. Providers, vendors, the government and others have spent billions of dollars moving healthcare into a digital world. It's an ongoing process, so people want to spend money wisely.

But why this sudden clarion call for change? Has so much gone wrong or not as expected? Are people more vocal, concerned about where EHRs are heading and wanting to reposition them and the industry? Or is it just serendipitous timing?

The issues raised this week--EHRs and patient safety, EHR design, data hoarding, etc.--are not new. But it seems like we're hitting a fever pitch.

What remains unclear is how to effect the changes, who should be spearheading them, what changes are best and which would be handled first. That's why it's harder to actually make the changes.

But it's getting increasingly harder to ignore the need. - Marla (@MarlaHirsch and @FierceHealthIT)

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