Wednesday, August 11, 2010

Meaningful Use or Meaningless Data

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The climb (path) to Meaningful Use

 

Today  MARGALIT GUR-AIRE waxed mightily in his writing on the Health Care Blog.  I like MARGALIT GUR-AIRE , a brilliant medical writer, who far exceeds my minimalistic attempts to display my inadequacies in the written word.

 

Meaningful or meaningless data?  It remains to be seen about the benefits of all this data. First of all the 'system' is currently 'non existent" except for relatively small silo's of information limited to established larger health institutions and/or medical clinics  that have integrated EHRs
Much of the stimulus funding for EMR by HITECH has been driven by empty promises for the potential of a unified data sharing system. The system as envisioned and yet to be implemented mandate of APPA will not even begin to grow until after 2014.  Larger portions of the country are not served by the broadband connections required to become a part of NHIN or even local HIEs.


And there will be a significant segment of providers who simply will not participate even with the incentives which are inadequate.
The larger question is who will even look at this data as it accumulates in storage media hidden away in systems deep underground in government systems that are already obsolete?? So not to discount all the experts in this era, while it all has great potential, there remains many visible pitfalls, and unknown barriers to the utopia of EMR. There is not much in it for the individual provider in terms of face to face patient contact other than medications, Rx Writing, and history and physical findings. And these metrics are difficult to obtain during a patient encounter, creating diminished efficiency whose cost will be transferred to fewer patient encounters, less time to talk to patients, and more, not less frustration for the provider.  We all would like to drive that BMW, but few can afford it, and many sell it when the warrantee ends.
But what do I know....I usually am correct and see ten or more years into the future, having experienced 40 years of medical practice.  My younger brethren have yet to experience the upheavals caused by well intended tsunamis that travelled through medical reimbursement changes in the past. But that will not matter in a health system that will largely become a civil service department of the government(s).

The Computer is  a  Moron (Peter Drucker, 1909-2005 elaborates further.

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