Members of a federal healthcare information technology advisory committee, looking back on nearly two years of its existence, listed among one of its "lessons learned" to not get too far ahead of the market.
The Electronic Health Records work group was created by the American Health Information Community in November 2005. The AHIC was, in turn, founded that summer by HHS Secretary Mike Leavitt to advise him on health IT policy.
Last year, the AHIC presented the EHR work group with its first round of healthcare activities, or "use cases," on which it was to provide advice and guidance. One of those use casesfor electronically moving test-results data from a laboratory to an EHRwas "too constrained" to be of much practical use in the real world in that it didn't provide for laboratory orders, specimen labeling or laboratory tracking, according to a PowerPoint presentation at the work group meeting Tuesday by Karen Bell, a physician work group member and director of the office of health IT adoption within the Office of the National Coordinator for Health Information Technology at HHS.
The laboratory use case also was "problematic," according to Bell. In addition to the EHR work group, the AHIC also developed a laboratory use case for another work group for bio surveillance, which prompted the federally funded Healthcare Information Technology Standards Panel to push for a data standard that could accommodate both needs, but ended up being too advanced for the market, according to laboratory owners and the federally funded Certification Commission for Healthcare Information Technology, which had adopted a less ambitious standard. The various organizations eventually compromised by creating a timetable to phase in the more advanced standard.
The work group is scheduled to make a series of formal recommendations on boosting EHR adoption to the AHIC in December. Bell, who pointed out the adoption rate of EHRs remains "very, very low at this point," around 10%, suggested some possible areas where progress could be made are in the field of healthcare IT workforce development. They include finding ways to better support IT workers in the current healthcare system and promote training programs to prepare the IT workforce of the future in both healthcare delivery and in other areas, such as product development and implementation.
Work group co-chairman Lillee Smith Gelinas, vice president for clinical performance at group purchaser VHA, Irving, Texas, said workforce development will implicate educators, providers and system developers. Gelinas said she foresees coordination as a hurdle.
"I see all the silos in the academic sector and in the practice sector and in the vendor sector," Gelinas said. "It would be very helpful if we could think of a recommendation or strategy that also pulls this all together.
"What drives some of these silos is the funding," Gelinas said, noting that specific groups in the academic and provider sectors obtain grants for certain projects, but the knowledge gained once the project is completed is often not shared. One possible remedy suggested was federal support for a workforce development coordinator.