In response to Joseph Conn's "Does 'meaningful use' still have meaning?":
Joseph Conn makes good points about the problem defining "meaningful use" of health information technology.
Since our nation's goal is drastic improvements in care efficiency and effectiveness (i.e., value to the consumer), it seems to me that mainstream health ITbe they electronic health records/ electronic medical records, computerized physician order entry, or even personal health recordshave minimal usefulness because they don't provide robust decision support. Truly useful decision support would bring about dramatic improvement in care quality and affordability. This means doing much more than offering warnings and alerts, which is the bulk of decision support provided by mainstream health IT systems.
Health IT tools should promote profound holistic understanding of each patient's particular problems, needs and preferences; a keen awareness of the pros and cons of appropriate treatment, prevention and self-management alternatives; and reliable guidance and useful feedback.
The missing ingredient is what the National Research Council of the National Academies calls "patient-centered cognitive support," or PCCS. PCCS is a computerized process that uses a "virtual patient model" to:
- Save clinicians time and energy by automating searching and sifting through a patient's clinical details and related research guided by a virtual patient model.
- Promote a deep and broad understanding of a patient's health status, including the interplay of biological, psychological and social influencespast, present and future.
- Provide effective, personalized decision support regarding diagnosis, treatment, prevention, and health promotion. And this decision support would help: account for patient preferences, qualities and circumstances, improve overall care value and continually evolve.
I contend, therefore, that PCCS be a requirement of "meaningful use."
Steve BellerPresident and CEONational Health Data SystemsCroton On Hudson, NY
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