Electronic health records provide the foundation for clinical excellence

I have mentioned this many times but it bears repeating with three
recent news articles – the electronic health record itself is not a
game changer but it is a powerful information gathering tool.

by gathering information in a single collaborative place, EHR
technology allows all clinical providers to measure, monitor, and begin
to improve the way they provide care. It is this later part, which is part of the overall organizational transformation enabled by the technology (not solely because of it), that allows an organization to achieve the promised high performance results of an often painful EHR implementation.

  • Kaiser achieves top ranking among California HMO’s. I have mentioned Kaiser before.
    They are well positioned to be the national leader, eclipsing the VA,
    because they have continued to heavily invest in the technology while
    the VA has essentially lost their lead due to political infighting,
    inept leadership, and general lack of vision (contrast this with the Indian Health Service which ROCKS under Terry Cullen’s leadership).
    Watch for Kaiser to extend their leadership with how they engage their
    patients and extend the EHR from the enterprise to the home.
  • Midland Memorial recognized as an Info World Top 10 Projects.
    I obviously am pretty pleased with this recognition as Midland was our
    first commercial customer. The focus of this award is the intelligent
    use of the public domain VistA software to literally transform the
    organization. They have begun to reap the clinical benefits, and will
    continue to do so as the software marinates and permeates their
    ancillary services. They have also extended the software in new and
    exciting ways that should give the entire code base a new life that the
    VA had strangled out of it after years of neglect.
  • GE Health Care wants to invest $200M in National Health Record.
    We are all familiar with GE’s excellence in all the things it pursues
    including their famed Top 2 approach to every industry. Well, given
    that philosophy, they should bail out of HIT and reinvest in their
    market leading imaging technology. The GE Health Care unit has
    floundered, and beyond some big names (including Mayo, IHC, and
    Montefiore), it has essentially been a market loser. After their very
    promising beginning, with their $100M partnership announcement with Intermountain Health Care,
    they have floundered. Their Centricity product, plus the indigestion
    with the IDX acquisition, has proven to be as dysfocusing as
    dysfunctional to integrate. While I applaud the effort and the
    intention, making a $200M investment in a national project is but a
    PITTANCE (See Kaiser’s $10B investment in Epic). I hope they
    keep the promise of making the “open architecture” available so that
    others may learn and adopt code that may be produced by this effort.

I anticipate many more efforts, announcements, and projects like the
above in the coming years. Particularly when we can agree on some
standards of information sharing wherein all these disparate efforts
can now work together. I also hope to see the ongoing collaboration
requirements yield to code sharing as part of their efforts
so that all these individual investments might work toward a common
goal: excellence in clinical outcomes and health care value.

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5 replies »

  1. Personal Health Records system collects all information pertaining to the patient, which includes past medical history of the patient, laboratory test results, medications etc. This allows doctors to have instant access to patients’ data, and can give right treatment with no delay, it offers secured storage of data. Regardless of the region and time, the authorized users can access the data for various purposes such as better treatment for patients, research of critical and peculiar cases, to avoid repetition of tests and etc.

  2. A response to “jd”–
    While there’s no killer app out there that addresses all aspects of what you describe, you might want to check out the “Pathways to Health” program in Michigan. By getting payers to align performance bonuses for a defined population (diabetes patients) they were able to facilitate the creation of a pretty elegant registry that contains details of the most critical clinical elements to support significant improvements in care quality. True, it’s not Kaiser, but it’s a start. It also goes to show that HIT deployment and provider payment reform are linked in some very interesting ways.

  3. One thing I’d like to see written about more here is the attempt to create a “virtual Kaiser” by linking provider-based EMRs with PHRs that are populated with EMR and health plan (claims-based) data. The EMR/PHR (some call this an EHR) would serve as the basis for physician coordination of care and be combined with tools that allow patients to communicate online with providers to schedule in-person appointments and have e-visits.
    There are two main questions: how close is anyone to being able to create this in the fee for service world from a technological perspective, and how close is anyone to creating this in the fee for service world from a systems (collaborative work flow) perspective. I’ve just begun to look into this, and it appears to be a very promising area where first mover advantage may be significant due to the network effect.