Health IT, Patient Engagement

A third perspective on the HITECH era: Why patients matter

In September, two articles in The New England Journal of Medicine presented differing perspectives on the HITECH era. Now, a new blog post from UCSF’s Center for Digital Health Innovation poses a third perspective focused on patients.

Careful observers will recall two differing perspectives published in The New England Journal of Medicine in early September. The articles clashed over the impact of the Health Information Technology for Economic and Clinical Health (HITECH) Act.

In one camp, four former national coordinators who served during the Obama administration (Vindell Washington, Karen DeSalvo, Farzad Mostashari and David Blumenthal) argued that the HITECH era was largely successful, having brought EHRs to most hospitals. Yet they didn’t deny that physicians struggle with EHR usability. Moving forward, they believe the industry must focus on interoperability and finding meaningful ways to utilize data.

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On the other side were health IT executives John Halamka and Micky Tripathi. They claimed a lack of infrastructure contributed to EHRs overwhelming physicians. Moving forward, the executives think the government should not be overly involved in EHR and interoperability efforts.

Despite these articles’ insights, there’s one perspective being overlooked: that of the patient.

In a recent blog post out of UCSF’s Center for Digital Health Innovation, four leaders (Robert Wachter, Michael Blum, Aaron Neinstein and Mark Savage) focus on the consumer-centric side of the equation.

As the blog writers note, a significant amount of a person’s health happens outside the 15-minute office visit. Social and environmental factors influence about 85 to 90 percent of one’s health, they state. Thus, using technology to help individuals outside the four walls of the hospital is of increasing importance.

Looking at the health IT realm through the eyes of a patient offers a completely different story. Consumers want access to their health information, but unfortunately, it’s often difficult to obtain — particularly electronically.

“How could we win patients’ hearts and minds if they still must find access to their health records in a basement office, request a form, fill it out, find a fax number, fax it, mail a $10 check, and hope for a CD ROM back,” the authors posit.

Many have highlighted the need to boost EHR usability for providers. But the leaders from UCSF’s Center for Digital Health Innovation note that an equally important question is: “[W]hat is the burden and impact on patients and individuals when EHRs and doctors do not provide the electronic access to one’s health information and health services demanded by 21st century needs?”

Though HITECH has paved the way for numerous advances, such as better online access to health information with mobile apps using open APIs, there’s still work to be done.

The HITECH Act provided a solid base for future advancements. Going forward, the authors see opportunity in digital tools that allow patients and providers to engage with each other. Finding a win-win for patients and doctors is the key next step.

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