The Future of the EHR is Now

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We are in the age of patient information sharing - and electronic health records are making it possible along with great effort from public and private groups focused on establshing standards and healthcare facilities that are investing in EHRs.

It is as though massive Tectonic plates of healthcare informatics have shifted and an earthquake of seismic proportions and ramifications in healthcare information technology (IT) has begun, according to Mark Leavitt, MD, PhD, medical director of the Healthcare Information and Management Systems Society (HIMSS).

A coalition comprised of the federal government, professional IT and medical societies, private foundations, industry leaders and experts in the field has resulted in adoption of standards that enable interoperability, and other groundwork that will lead to the development of national health information networks. Thirty years in the making, the era of electronic health records (EHRs) - where secure and private patient clinical information and medical images can be shared safely and efficiently across the healthcare enterprise, the community and even across the nation - is upon us. IT professionals are ideally positioned to guide their institutions through the necessary steps to enable smooth transitions into the changes that are coming.

Digging Deeper: URLs of Interest for EHRs

Office of the National Health Information Technology Coordinator (ONCHIT)

SNOMED International

The Regenstrief Institute

The Markle Foundation

Connecting for Health

American Academy of Family Physicians Center for Health Information Technology

HIMSS Ambulatory EHR selector

CareWeb at Beth Israel Deaconness Medical Center
Patient site
Clinical portal
Powerpoint presentation with screenshots

"We are on the verge of the golden decade of healthcare IT, as it rolls out and becomes part of everyone's professional life in healthcare," asserts Leavitt. He suggests that these IT activities have moved from the position of questioning whether or not electronic health records are possible to the understanding that the sharing of clinical data are imperative and must be accomplished and the only question is what steps are vital to meeting this mission.

UNCLE SAM & COMMUNITIES UNITE

Public-private initiatives on the national and local level have begun to propel the development of interoperable networks to facilitate secure sharing of patient information between healthcare providers on a "need-to-know" basis. The federal government has established the Office of the National Health Information Coordinator (ONCHIT), headed by David Brailer, MD, to assist with coordinating efforts of the vendor community and healthcare providers designed to drive these endeavors forward. Professional medical societies have placed emphasis on enhancing their members' use of electronic solutions to information sharing. And many communities have begun establishing networks to connect their disparate healthcare providers to central data repositories.
 
The Markle Foundation in New York City convened the Connecting for Health Steering Group comprised of more than 50 leaders and decision-makers in healthcare to promote voluntary adoption of data standards and communication protocols for the sharing of healthcare information in 2002. In January, they renewed their commitment to advancing the use of electronic connectivity in healthcare.

David Lansky, PhD, director of the health program at the Markle Foundation explains that currently, we have an incredibly fragmented, complex and sub-specialized medical care system, which means that specific information about any individual patient is difficult to collate for use.

"The Markle Foundation's work in this area is to support interoperability from the very granular level of specific data standards that need to be adopted uniformly, to the policy level of encouraging governmental agencies and others to do their work in such a way that it encourages standardization and interoperability," says Lansky. IT professionals must become informed about the scope of these activities, and learn specific steps necessary to insuring smooth integration into regional information systems of the future.

CURRENT REALITIES

As healthcare IT has evolved over the past 30 years, from IT activities solely directed at managing the financial aspects of a healthcare institution to the introduction of departmental IT systems to the current state of enterprise-wide IT solutions that integrate all of the disparate departmental