Obama’s push for digital health records and what I think its flavors should be

While our new administration is doing the right thing by pushing for the modernization of our healthcare system, it is important to have a plan that will work and motivate everyone in the healthcare industry.
In my view the 5 year timeframe that our government is looking at will be very short to accomplish EHR implementation and standardization, especially in the small to mid size medical groups. In working with some of these types of offices in the last 10 years, I realized that many of them have complex workflows, and many encompass diverse delivery systems while many still suffer from the lack of proper infrastructure (Backups, server hardware requirements, scanners, efaxing,…etc.).
It is important to note that, in order to overcome the daily challenges that these groups are faced with (small IT Budgets, lack of HIT knowledge, and few uncooperative providers, high software costs), the new administration will have to create a road map that will impose some standards and also still be flexible by having different flavors of the modernization plan.
The package that should be offered will offer different options for different models as shown below:

Small Size Practices

• The offering of a complete web based solution (PMS/EMR) that will eliminate having to make large IT hardware/software investment, and still allow the practice to have EHR. Which package is needed would be a another blog subject).
• An option for the practice to use an EMR package that has been certified and approved by a Healthcare body.
• Educate the practices of the advantages of medical data sharing.
• Strong financial incentives in form of tax breaks or grants to offset the costs of time spent in training, and other requirements to get the new system going.
• Appoint at the state level a body that does nothing but consult with the practices and make sure they are seeing the benefits of such a system.

Mid Size Practices

• Work with these groups and allow them to keep using their current systems to maintain their patient medical records. Since these are the groups that have long implemented successfully many of the EMR packages that are offered.
• Provide financial incentives if they choose to migrate to a new EMR package.
• Provide financial / technical assistance to interface these systems to a central data repository. Similar efforts have been seen working with RHIOs where there is a substantial amount of resources needed to accomplish this.

Community health systems and hospitals

• I think we can all agree here that based on many of the recent statistics that still a larger number of hospitals are using electronic health records. So, the need here would be to centralize or allow for data sharing with the central data repository.

The only thing that I would add is that the effort should be shared amongst government and non government entities. Many health groups have successfully implemented some sort of central data repository where information is being exchanged and shared. The government role should be to enforce the standards, and offer reward to those who take the initiative to get on board.