Health IT

DeSalvo: True EHR interoperability – and a national HIE – is possible by 2017

Dr. Karen DeSalvo, national health IT coordinator

Dr. Karen DeSalvo, national health IT coordinator

America can achieve widespread health information exchange by 2017, according to newly minted national health IT coordinator Dr. Karen DeSalvo. “We can do national healthcare exchange in three years,” DeSalvo said Thursday at the 2014 Healthcare Information and Management Systems Society (HIMSS ) conference in Orlando, Fla.
Americans should be able to take for granted that results, records and care plans are available anywhere, DeSalvo explained during a keynote address on the final day of HIMSS14. “I want this as a doctor, I want this as a patient, I want this as a daughter.”
She envisions complete capture of standardized healthcare data, including patient-generated information. Perhaps with less panache than White House Chief Technology Officer Todd Park — who has enthusiastically championed “data liberación” in healthcare since the early days of the Obama administration — but still with conviction, DeSalvo declared: “The nation’s healthcare data will be freed.”
Today, however, most healthcare data still resides in silos, and electronic health records still do not often reach to behavioral health, long-term care and other settings beyond the walls of the hospital or doctor’s office.
Privacy, security and patient identification remain serious challenges, the coordinator told reporters following her speech.
“This issue of patient matching and making that we get that right is very important,” DeSalvo said. As data segmentation technology and standards advance to help patients manage sensitive parts of their medical records, EHRs will be able to help more people in more ways, DeSalvo said.

Despite these obstacles, DeSalvo sounded an optimistic note during the keynote. “I know that this is possible. I have seen [health information exchange] in every part of our country,” she said.

She expressed a belief that all the hard work done by her four predecessors as national health IT coordinator is starting to pay off, nearly 10 years after the birth of the Office of the National Coordinator for Health Information Technology (ONC).
“We are indeed making great progress as a country with health IT,” DeSalvo said. “Physician EHR adoption has surged in all corners of our nation.”


DeSalvo noted that two-thirds of doctors nationwide are e-prescribing through an EHR. And nearly 90 percent of hospitals have achieved Stage 1 of the federal EHR incentive program known as Meaningful Use, “well above the target goals set by us,” according to DiSalvo.

A public health professional, DiSalvo said she is particularly happy that about half of rural primary care physicians and 80 percent of federally designated critical-access hospitals have gone digital, and she thanked the Health Information Technology for Economic and Clinical Health (HITECH) Act for that. The HITECH Act, which marked its fifth anniversary Feb. 17, created the $27 billion Meaningful Use program, formally codified ONC and gave the federal government new tools to help promote health IT.

“It is clear that HITECH has accelerated process in this first decade,” DiSalvo said. It was in May 2004 that then-President George W. Bush created ONC by executive order—though without a stable source of funding—and challenged the nation to deliver comprehensive, interoperable EHRs to “most Americans” by 2014. Five years later, President Barack Obama upped the ante to “all Americans” as Congress was getting ready to enact HITECH as part of the $831 billion American Recovery and Reinvestment Act.

“It is clear health IT has been very successful in many ways to improve the care of patients in America,” DiSalvo said. “It’s beginning to show an impact in improving health.”

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