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Wednesday, April 28, 2010
Q&A
Beth Israel CIO Halamka: Electronic medical records are about policies, not just tech
By James M. Connolly
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Several New England executives are active in regional and national initiatives to advance health information technology and electronic medical records. One is Dr. John D. Halamka, who serves as chief information officer of Harvard Medical School and Beth Israel Deaconess Medical Center. He is CEO of MA-SHARE, chairman of the New England Healthcare Exchange Network LLC (NEHEN), CIO of the Harvard Clinical Research Institute (HCRI), and an associate professor of Emergency Medicine at Harvard Medical School. Scheduled to address the National HIT Conference in Boston this week, he recently spoke about health information technology and electronic medical records with Mass High Tech Managing Editor James M. Connolly.
What kind of changes have there been in the “meaningful use” and electronic medical records specifications in recent months that the IT community needs to be aware of?
“It’s not about what IT needs to do to solve this, it’s about collaboration of all the stakeholders. Everybody has to work together. It’s not about ‘hey, here’s a cool piece of software,’ it’s about how you use it. With our 2011 to 2015 goals, we’re going to be on an escalator. We’ll be defining not so much the technology that we’re going to use but how the business processes are going to change.”
What’s the business opportunity for companies offering software, hardware and services in health information technology?
“What’s the total size of HIT in America, $25 billion? The total of the stimulus bill associated with HIT is $23 billion. We are going to almost double the size of the HIT industry. There’s no other part of the (American Recovery and Reinvestment Act) that doubles an industry.”
So the opportunity isn’t just about hardware and software.
“Take every hospital in Massachusetts. Every time a clinician can’t boot their machine, they are going to have to call someone. In-house IT won’t be able to do it all. Think of all the service companies that will be installing and maintaining desktops, networks and printers. … There will be implementation and training for vast numbers of users. It’s a huge services opportunity.”
What are your thoughts on the iPad?
“We had them in here right away. They are the right size, and one of the best parts is that you can wipe the screens clean with disinfectant.”
How do you see the acceptance of EMR and the related technologies?
“With the clinicians, it’s sometimes a generational thing. You have some in their 50s and 60s who may be reluctant, but today’s medical student lives and breathes the Internet and technology.”
How can CIOs approach EMR?
“CIOs have to complete about 25 projects to achieve meaningful use. So if you look at the entire regulation, it seems overwhelming. But when you break this up into discrete chunks, it’s very doable. … One of the things being discussed is that, instead of having the whole thing be a pass/fail, tell people that there are 10 things that have to be done. Then they can pick five of the next 10 to do. This idea of partial credit will really catch on.”
How much of this is about projects that they would be doing anyway?
“Almost all of it. The issue is the time frame.”
Where are the specifications in terms of privacy and security?
“You can’t do health-care information exchange until you can ensure it’s secure. With all of this cool technology, you have to have the policies, and many groups are working to make sure that the policies are there before the technology gets deployed.”
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