Feature articles by: Christina Beach Thielst, FACHE, and Denny Angelle and Clare L. Rose, FACHE

Healthcare delivery in the United States is on the path to transformation through information. In our new world, we’ll have access to data that we can use to make decisions that improve the quality of the care we deliver, address the health of our society from a population health perspective, reduce medical errors, and analyze and drive waste and overuse out of the system. This exciting time brings with it the promise of transformation at the very heart of healthcare delivery.

Transformation is exciting, but that does not mean our healthcare system is without its strengths. Healthcare workers can perform amazing feats and mend broken bodies. However, the system has a critical weak link at the core of its infrastructure. We need information—clinical information that is centered on the patient—and we need to be able to analyze, understand, share, and use that information wherever the patient enters the system.

The process of transformation is, and will continue to be, a difficult path. The good news is that we are traveling confidently down that road. As David Bernd and Peter Fine say in their feature, “there is no turning back the clock.” A recent report from the Office of the National Coordinator for Health Information Technology (HHS 2011) reveals that 80 percent of hospitals and 41 percent of office-based physicians plan to implement an EHR and take advantage of the meaningful use incentive program. The investment that has been needed for so long is finally being made.

Skilled leadership is vital to the success of that investment. The path to transformation is riddled with roadblocks, one of which is end users’ reluctance or refusal to adopt new technology. Bernd and Fine note that “innovation requires that leaders push highly educated people into new processes that change their habits. This disruption can result in resistance—sometimes aggressive resistance—to innovative solutions such as EMR and can derail implementation efforts.” EHR adoption requires all the vision, determination, and charisma that the CEO and other leaders can bring to the undertaking. It may also require tough love. EHR implementation and adoption cannot be allowed to fail because of the foot-dragging of those who would rather stay behind.

Not only do we have the opportunity to transform care delivery, we also soon will have the information tools to improve population health. Without taking our eyes off the demands of the individual episode or the single chronic condition, we will better understand the factors that affect population health and how to improve the health of entire population segments. Chronic conditions account for about 80 percent of our healthcare costs (Health PAC 2011). M. Michelle Hood outlines the opportunity to improve population health: “Including preventive and early intervention protocols in our care transformation models, again enabled through IT -dependent disease registries and other IT -dependent population health tools, will further strengthen the likelihood of better patient outcomes.” The EHR, however, is not an end unto itself. It is one element of infrastructure needed to achieve a vision in which healthcare delivery is truly patient centered, in which clinical information flows readily to patients and providers no matter the venue of care, where preventable medical errors are prevented, and where patients have access to information to fully participate in their healthcare. If we are to realize the full potential of the time, money, and opportunity investments being made in EHRs, we need, more than ever, visionary, wise, firm, and inspiring leaders.