The jury is still out as to what will be included in the official definition of meaningful use when it is finalized in the spring of 2010, but the Office of the National Coordinator has made it clear that meaningful use will, at the very least, encompass the use of EHR technology to perform functionality like ePrescribing; electronic exchange of health information to facilitate care coordination; and quality reporting. Clearly, health information exchange will be an imperative piece of meeting the near-term objective of meaningful use.
But looking beyond 2011, 2013, or 2015 – beyond meaningful use into the broader arena of healthcare reform and evolution – is where I see the vital importance of health information exchange revealing itself.
The wave of national healthcare reform goes beyond simply covering the uninsured; it proposes a redesign of the healthcare delivery system as we know it in order to improve care while simultaneously containing costs. We are seeing healthcare delivery models emerge like accountable care organizations (ACOs) – which were incorporated into the healthcare reform bill recently passed by the U.S. House of Representatives – and patient-centered medical homes (PCMH). These integrated healthcare models may be the foundation for the future of healthcare delivered across America. They provide a comprehensive approach to managing the health of a patient and are predicated on enabling partnerships and collaboration across all constituents involved in delivering care (hospitals, physicians, payers, ancillary service providers, etc.).
New models of healthcare reimbursement are also being proposed – representing another significant change that would remake the healthcare market as we know it. Bundled reimbursement, which combines compensation for a given diagnosis or clinical problem into one payment across acute care and ambulatory settings, is perhaps the most frequently cited of these reimbursement models.
The common denominator in realizing these care-delivery and reimbursement models is the need for collaboration among healthcare stakeholders – the need for sharing information. Essential, therefore, to surviving – and succeeding – in the evolving healthcare market is connecting all stakeholders involved in providing healthcare to a patient. These connections rely upon comprehensive, real-time information about patients, across all acute care and ambulatory care settings, and empower caregivers with applications that optimize workflow and improve patient care.
Implementation of an EHR to meet meaningful use requirements isn’t enough to prepare for the future of healthcare. When making an EHR implementation decision, the ability to connect that EHR to the community needs to be in the forefront, because that is where healthcare is headed.
Furthermore, any viable HIE technology must enable stakeholders to meet requirements today (such as demonstrating meaningful use and submitting quality measures) as well as evolve to meet potential future requirements like bundled reimbursement without necessitating a technology overhaul. This means that a technology solution’s flexibility will be key to success in the future healthcare market as ACOs, PCMHs – and delivery models that haven’t even been conceived of yet – become reality.
