Want shared EMRs? Drop the technology debates

While everyone would like to see workable standards in place, the industry's data sharing efforts are still at the rudimentary stage. And for the foreseeable future, I'd argue, it's going to stay that way. Sure, the Certification Commission for Healthcare Information Technology (CCHIT) is busily certifying ambulatory EMRs--it's given 90 EMRs the nod to date--but private sector efforts aren't getting as far.

Of course, interest groups within the industry, notably Open Source fans, are working to create secure, interoperable records, but to my knowledge, none has tremendous mindshare. And I could be off base here, but nobody seems to be that excited about the CCHIT's efforts other than the vendors getting the certifications.

Given the complexity of the integration problem, perhaps a technical solution isn't the answer here. But if so, what models exist for a nationally-interoperable EMR system?

One, perhaps the most painful, might be for CMS to pick a vendor of choice and demand that every Medicare provider sign on. (Mind you, I'm not suggesting it has any such plans...just speculating here.)

Another might be if a major health insurance trade group such America's Health Insurance Plans were to pick their favorite EMR vendor and have its members push their providers to buy in.

Still another model might be a gradual accretion of functions. CMS or legislators could require providers to implement one health data app, and once they were used to it, gradually add to requirements until providers had complete EMRs in place. Hey, the National ePrescribing Patient Safety Initiative is already offering free, Web-based access to e-prescribing.

And what about the state of New York's approach? The state has begun giving free EMR technology to practices that treat a high volume of Medicaid-insured or uninsured patients. While I realize this may not scale financially, the idea's still worth a look.

So what do you think will work? Drop me a line and tell me how you think the U.S. healthcare industry can resolve the EMR adoption problem (preferably sometime in our lifetime). Can it be done? I'm keeping my fingers crossed. - Anne

P.S.: Make sure your physicians aren't creating a big, ugly security hole when they access your network remotely. More info

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