Hospital Impact: The more health information technology changes, the more HIT stays the same

The concerns in 2011 around the Meaningful Use program seem sort of quaint compared to the issues of today.
Marla Hirsch
Marla Durben Hirsch

It’s amazing how much has changed—and how much has not—when it comes to electronic health records since I first started covering the topic as a freelancer for FierceHealthcare more than five years ago.

Just look at the topics I was writing about back then. In 2011, Meaningful Use was in its infancy, vendors from outside the healthcare industry were flocking to set up shop, there were discussions about “early adopters” and physicians who refused to consider transitioning from paper records. 

The more HIT changes ... 

Remember the disputes about adding certain providers into the Meaningful Use program, what the program would look like, and how fast it would roll out? How strong the EHR market was? And whether EHRs really helped providers to bill inappropriately or merely let them capture the reimbursement they were entitled to but had previously been leaving on the table?    

Some of those big questions and concerns now seem sort of quaint. The Meaningful Use program has evolved in fits and starts, and for physicians it’s been supplanted by MACRA’s new incentive program.

EHRs are now commonplace. The industry has turned its focus to better EHR use, such interoperability along the entire care continuum and the harnessing of big data for initiatives like clinical trials and precision medicine. CMS’ payment programs, not Meaningful Use, are now the drivers spurring EHR adoption. 

Cybersecurity now involves fending off regular cyberattacks with sinister intent. Now we worry about EHRs integrating with patient-generated information, wearables and the Internet of Things.

We’ve been through multiple sets of regulations on the stages of the Meaningful Use program, EHR certification editions, stopgap measures softening the requirements, and proposed regulations that were scrapped. Even ONC’s role has shifted.

The more HIT stays the same

And yet some issues don’t seem to change at all. My editorial columns from 2011 addressed the need for providers to conduct those required security risk assessments, the high number of HIPAA breaches attributable to electronic snafus, EHRs’ usability issues, patient engagement, the inaccuracy of patient information stored in EHRs, EHRs and health disparities, EHRs and patient safety, and the disconnect between providers and vendors. 

Sounds familiar, doesn’t it?

And for some issues the pendulum swings back and forth. More regulation or fewer? Standardize systems or not? One national health network or more local health information exchanges? More oversight or more free market?

I considered myself pretty savvy when I first started writing about EHRS for FierceHealthcare in 2011. I quickly learned that EHRs and health IT were much more complex and their impact more far reaching than I realized. That there are untold people--providers, vendors, government staffers, and others--who care deeply about health IT and its future.  

I have a deep appreciation for those in the trenches who are doing their darndest to make these systems work the best that they can and to make the laws and rules work the best way that they can. They have not lost sight of that triple aim, even as we head into uncertain territory

As I move on to other endeavors, I want to express my deepest thanks to those insiders, experts, colleagues at Fierce and sources who helped me in this one. Most of all, thank you to my readers. I hope I’ve provided some news and insights that were useful. It’s been a pleasure.

Marla Durben Hirsch is an attorney who has specialized in health law for more than 30 years and has written about the many facets of healthcare for almost 20 years—including as a contributor to FierceHealthcare. She has won a number of awards for her coverage of healthcare news, and has been quoted in several publications, including the New York Times.