EMR development debate focuses on standards, competition

Lest anyone think the issue has been settled, national health IT coordinator Dr. David Blumenthal says there is a "raging debate" in scientific and policy circles about whether standards or competition should drive EMR development, MassDevice reports.

"There is a raging debate in the computer science world, which I have only lifted the lid on because I'm not a computer scientist, but it goes basically like this: Do we want a world where somebody sets very detailed standards for what computers have to do in order to create interoperability? Or do we want a world that's a little bit more like the Internet, where a minimal set of standards was created and an enormous, vibrant competition and spontaneous growth occurred?" Blumenthal reportedly said at a gala for the Lucian Leape Institute of the National Patient Safety Foundation.

"I hear both sides of that argument, constantly, and even those people who believe in the minimal set of standards aren't really sure what that minimal set is, but we're working on precisely that," Blumenthal added.

He was responding to a question from former U.S. Treasury Secretary Paul O'Neill about EMR standardization.

"Why is it that we're reluctant to declare that we are going to design the best prototype that we can with an idea that we will have [iterative versions] as we learn more and we identify more needs?" wondered O'Neill, himself now a patient-safety advocate. "Why is it that we can't call to question and get on with what's a clear and apparent need for a national standard that's a work in progress?"

"It's not that it has to be perfect from day one, but your office basically says, 'We're going to do this now'?" O'Neill asked. O'Neill noted that he had seen the "travesty" of a $500 million investment in a proprietary EMR that was not interoperable with competitive systems, something that's "not worth a damn" when a patient travels outside the local service area, and he does not want to see others waste money like that.

Blumenthal also addressed the recent news that medical licensing boards may require health IT competency for physicians to keep up their licensure. "Information is the lifeblood of medicine, and unless physicians and other healthcare professionals are capable of using the most modern technology available for managing information, I think they will have trouble claiming, in the 21st century, the unique competence that entitles them to being licensed and board certified," Blumenthal reportedly said at the NPSF event. "I think they'll have trouble holding up their heads as professionals and claiming that they are at the top of their game and capable of providing the best care that technology allows."

To learn more:
- take a look at this MassDevice story

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