On April 13, 2010, the Wall Street Journal published two fascinating articles on health information technology issues. In "Can Technology Cure Health Health Care?" author Jacob Goldstein examined the complexities and major risks of adopting electronic medical records. Goldstein also suggested a few high-level policies necessary to combat such risks, including designing the software with patient care in mind (rather than focusing on billing and other administrative tasks); customizing the software to fit the unique needs of one's organization; and taking the time to implement the EMR in a carefully crafted, staged manner.
The last recommendation seems to be indeed crucial to a successful EMR implementation, but it will likely put many healthcare providers trying to capitalize on HITECH incentive payments in a peculiar situation. Such providers must carefully balance their need to achieve "meaningful use" in a short time frame, while preventing as many disruptions to patient care as possible.
In "Breaking Down the Barriers," Laura Landro examined the state of regional health organizations (RHIOs) and health information exchanges (HIEs). While RHIO/HIE's are still rare, the number of such electronic patient data exchanges grows every day. In fact, according to the Journal, the number of RHIO/HIE's increased by 57% since last year. Such exchanges are also likely to benefit from HITECH Act funding distributed by HHS.
There is an interesting nexus between these two articles: interoperability and exchange. A successful widespread adoption of EMR technology seems to depend upon different EMRs talking to each other, and different - including competing - healthcare providers exchanging patient information. While EMRs may only marginally improve patient care in each individual hospital, they are likely to have a far greater impact as part of a nationwide health information exchange.
"Can Technology Cure Health Care?" Wall Street Journal (April 13, 2010).
"Breaking Down the Barriers," Wall Street Journal (April 13, 2010).
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HHS's Office of Civil Rights (OCR) filed a notice in the Federal Register lifting a requirement preventing OCR from posting names of sole practitioners who suffer breaches of patient data without first obtaining consent from such practitioners. Pursuant to the HITECH Act, any covered entity reporting a breach affecting over 500 individuals must report such breach to HHS, and HHS will post a notice of such breach on its web site. At the same time, HHS did not post names of individual physician practices (e.g., sole practitioners) without such physicians' consent because they deemed the name of the physician to be protected under the Privacy Act of 1974. Instead, HHS listed such breaches under "private practice." However, OCR announced on April 16, 2010, that "it will begin posting on its breach notification web site the names of entities they consider "individuals" regardless of whether or not those entities give consent." According to HealthLeaders Media, the rule will become effective after the comment period closes (about May 23, 2010).
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In a letter to Dr. David Blumenthal, the College of Healthcare Information Executives (CHIME), an organization which represents1,400 healthcare chief information officers, offered some criticism of ONC's recent notice of proposed rulemaking (NPRM) regarding the EHR certification program. While CHIME expressed general support for a two-stage approach for creating the certifying bodies, the CIO's are worried about any destabilizing effects such rule may have on the health IT market. Via .gif){kind=logo}
A group of 37 U.S. Senators sent a 
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The Office of National Coordinator for Health IT (ONC) 