Does Your Doctor Use An EHR?

The latest statistics are out regarding the adoption and use of electronic health records (EHRs). The New England Journal of Medicine published the government sponsored survey report. Check out the article in the NY Times, "Most Doctors Aren't Using Electronic Health Records." (full report - Electronic Health Records in Ambulatory Care -- A National Survey of Physicians).

The article indicates that only 9% of medical practices with less than 3 physicians have adopted an EHR -- while the percentage increases to 50% for those practices with 50 or more physicians. The comments in the article by one physician seem to confirm a recent conversation with Jack Shaffer, health IT specialist, that EHRs don't necessarily improve physician efficiency.

West Virginia native, Dr. Brailer, is quoted in the article:

But the new study is based on a large sampling — more than 2,600 doctors across the country — and a detailed survey, making it more definitive than past research, experts say. The results, they say, also show a strong endorsement of electronic health records by doctors who have them, especially for what the report termed “fully functional” records, which include reminders of care guidelines, based on a patient’s age, gender or medical history.

For example, 82 percent of those using such electronic records said they improved the quality of clinical decisions, 86 percent said they helped in avoiding medication errors and 85 percent said they improved the delivery of preventative care.

“Those numbers are huge and very encouraging,” said Dr. David J. Brailer, the former health information technology coordinator in the Bush administration.

Dr. Brailer also pointed to the 54 percent of doctors without electronic health records who said that not finding an electronic health record that met their needs was a “major barrier” to adoption. In short, they are not satisfied with the existing products, which tend to be designed for hospitals — big customers — instead of small practices.

“What we see is a deficit in innovation, and that is something innovators and the capital markets can address,” said Dr. Brailer, who leads a firm that invests in medical ventures, Health Evolution Partners.

AthenaHealth is also mentioned in the article. Over the last several months I have been thinking about whether a web based service as software approach, like AthenaHealth, might be an method to grow the adoption of EHR usage in West Virginia as a part of the West Virginia Health Information Network.

The report finding that that most doctors are not satisfied with existing technology should give Dr. Parkinson via Hello Health and other health 2.0 innovators a positive sense of opportunity.

WVHIN Board Meeting (January 2007)

On Friday the board of the West Virginia Health Information Network (WVHIN) met and covered a variety of topics and continued its efforts to coordinate the creation of a successfully integrated health information system. (Note: The WVHIN board is still in the search phase for an Executive Director).

Topics of the board included the following:

1. A status report on the submission of Interim Report of the West Virginia Solutions Group under Health Information and Security and Privacy Collaborative (HISPC). A motion was made and passed to integrate and continue to carry on the HISPC project work under the auspices of the WVHIN after the project grant is completed in 2007.

2. Update and approval of the WVHIN Bylaws, including a letter from the State Ethics Commission approving the form and substance of the Bylaws and indicating that the Bylaws meet the open meeting law requirements in West Virginia.

3. An update on the pending e-prescribing legislation (Senate Bill 69) introduced by Governor Manchin to address the current restrictions on allowing e-prescribing by physician and pharmacists in West Virginia. There were also a number of e-prescribing presentations providing the details of how such systems will work and current statistics on e-prescribing in West Virginia and nationally.

4. An update on the FCC Broadband Grant application process.

Included in the handout materials for the board meeting was a copy of a recent article appearing in Health Care's Most Wired Magazine by my fellow board member, Sarah Chouinard, M.D. Interesting article (see next post).

Tags: WV, West Virginia, health care, WVHIN

WVHIN Executive Director Wanted

In 2006 I was appointed to serve a four year term as a Board Member of the new West Virginia Health Information Network (WVHIN). The WVHIN was created in 2006 to help guide the state's efforts and oversee the implementation of a private/public interoperable health information system for West Virginia.

Last week I was speaking with Sallie Hunt, Chief Privacy Officer for the State of West Virginia, who has been instrumental in overseeing the initial activities and assisting with the startup of the WVHIN. She advised that they are now in the process of searching for a full time Executive Director. If you are interested in applying for the position or know of someone who might be interested, please contact Sallie Hunt at (304) 558-7000 Ext. 252.

Sallie provided me with the following summary of the Executive Director job description being used by the search committee.

The Executive Director (ED) is the primary executive officer of the WVHIN, reporting to the WVHIN Board of Directors. As such, the incumbent is responsible for assisting the Board to develop the policies and procedures of the Health Information Network (the WVHIN), for implementing these policies and procedures, and for initiating a periodic review of these policies and procedures.

The ED is responsible for the overall administration and management of the WVHIN. This responsibility includes planning and evaluation, policy development and administration, personnel and fiscal management, public education, provider recruitment, business model development, and media and public relations. The successful candidate will have excellent problem-solving skills, be a self-starter, have an entrepreneurial spirit, and be able to function with minimal supervision.

This position will be the "public face" of the WVHIN and, as such, the incumbent will have to have strong speaking, presentation development and writing skills, with the ability to convey highly technical issues in a clear and compelling manner. The incumbent will have to interact regularly with a wide variety of audiences—healthcare providers, potential and existing funders, policy-makers and executive leaders, consumers, and vendors—and will need the skill to drive and balance a multi-stakeholder constituency group.

The ED will be responsible for developing, maintaining, and engaging in a relationship with the vendor directly providing the technology services of the WVHIN. Thus, the incumbent should have contract management skills and preferably the ability to manage a highly technology-dependent project.

Finally, the ED will have the personal qualities that enable him/her to work comfortably in an environment characterized by significant uncertainty. With the possibility of the governance structure changing and ongoing fund development needs, the ED will spend significant time and energy assisting the Board of Directors and other state stakeholders to arrive at decisions that assure the WVHIN a clear strategic direction and long-term viability. The incumbent must be comfortable working with diverse organizations and in maintaining a balance among competing interests. This balance sometimes requires making difficult decisions to keep the project on track.

Tags: WVHIN, WV, Charleston, health care, technology