Despite our EHR successes, most hospitals are a “Tower of Babble,” with numerous modules and devices unable to talk to each other without costly interfaces, overlays, or, in many cases, a nurse or other healthcare professional serving as a translator, manually transferring or transcribing data from one system to another.
It is sobering to realize that hundreds of millions of dollars were spent experimenting on how to get patient X's information from Ohio to Florida, yet we cannot convey data from a digital blood pressure cuff into an EHR three feet away without some type of work-around. This reflects yet another missed opportunity to invest in solving a concrete connectivity problem that adds cost, reduces efficiency and diverts the focus of clinical staff away from patient care.
We are at a critical juncture in the automation of our healthcare system. The window to earn incentive payments for EHR adoption is closing, and the financial penalties for noncompliance are real. In these tight fiscal times, it is difficult to imagine where the funding will come from to robustly address any one of these missed opportunities, absent the private sector rising to the occasion.
HITECH's stated goals in 2009 of reducing errors, bringing down costs, ensuring privacy and saving lives are still the right goals for patients, providers and the healthcare system as a whole. Yet, absent interoperability, macro or micro, their prospects seem shaky at best.
As we look to the future—to Stage 3 meaningful use and eventually a post-HITECH world, it is critically important to continue striving to realize the law's larger vision for health information technology. At the same time, one “lesson learned” should be never to underestimate the value of taking a concrete step, such as moving information from a digital blood pressure cuff into an EHR a few feet away.