Feature articles by Michael A. Sachs and Rosemarie Nelson
This issue of Frontiers focuses on information technology, most specifically the electronic health record (EHR). The EHR has been “in the works” for at least a decade, but progress has been slow. The obstacles to implementing a truly seamless system have been many—identifying the right technology, finding the money to pay for it, getting buy-in from key stakeholders, and creating universal standards. Although not a panacea for the many problems of our fragmented healthcare system, the benefits of a robust EHR system will be profound—it is expected to dramatically reduce costs and greatly improve the quality of patient care. Given the complexity of the issue, we asked five experts in the area of healthcare information technology for their views, insights, and some answers.
In “Transforming the Health System from the Inside Out,” Michael A. Sachs, a healthcare strategist and visionary, describes what an information-enabled health system will look like in 10 to 20 years. To get to this point, Sachs suggests that incentives for IT adoption need to be used effectively. He describes a model of public-private collaboration, with incentives such as pay for performance and reporting requirements from both private and government payers, and the creation of a marketplace that fosters both collaboration and competition.
Rosemarie Nelson, a national leader and consultant representing medical groups, provides a discussion of the issues involved in converting a physician group from a paper-based clinical documentation environment to a paperless, electronic operation. In “Connecting the Providers in Your Healthcare Community: One Step at a Time,” she describes the factors for success and advises physician offices to adopt an incremental approach that would allow everyone in the group to experience small victories with little risk of failure until they’re ready for the next step. She provides a Sample Readiness Self-Assessment Tool for physician practices looking at EMR adoption.
The three commentaries explore the issues raised in the above articles. The presidential mandate to have an electronic medical record system in place within 10 years has no doubt reinforced the efforts of the various stakeholders to move ahead on implementing the EHR. But obstacles remain. The contributors to this issue of Frontiers have explored the potential, examined the obstacles, and provided some insights as to the best way to get from here to there. One thing is for sure—the EHR is going to happen. Whether or not it meets its full potential will depend on all of the stakeholders working together to achieve an optimal blend of technology, financing, and leadership.
Audrey Kaufman, Editor