It’s been an interesting week here in Boston, though it was a visit extended by an extra day due to the weather here in the northeast — but at least it wasn’t held in DC! I was privileged to be invited to chair a panel at this week’s Health Stimulus Exchange conference, which was not only well-attended, considering the weather, but well worth it, too, both for the content and the pedigree of the speakers. The conference was held at the Hyatt Harborside Hotel, overlooking Boston Harbor – at least I think I saw it out my window before the fog and snow set in.
What better place to have a conference on the future of healthcare IT than here in Boston, Massachusetts, arguably ground zero of the 30+ year effort to integrate IT into the fabric of the healthcare industry. Boston is the birthplace of MUMPS, COSTAR and telemedicine; home to Partners Healthcare, the Mass e-Health Collaborative, MASSHARE, Dr. David Blumenthal and some of the most innovative and successful HIT efforts in the US to date. Thanks to these efforts, the adoption rate of EMRs in physician office practices within a 10 mile radius of Boston now stands at 76%, according to figures released at the conference by Dr. David Bates of Harvard, a longtime — and high profile –advocate of health IT. Massachusetts is also the state that has become the poster child for the Obama administration’s vision of healthcare reform – a state where well over 90% of the citizens have at least basic health insurance coverage. Although hardly representative of HIT adoption nationwide, Massachusetts is, nevertheless, a model that the rest of the country should find worth emulating.
My last posting dealt with Meaningful Use and the steep hill the industry must climb to achieve it, and pocket the pot of gold at the end of the rainbow. There were two interesting factoids that I heard at the conference that suggest the hill is as steep – perhaps even steeper – than many fear. I wanted to share them with the readership and ask for thoughts and comments.
The first came in a presentation given by Dr. Bates and Dr. John Halamka; the second came from a presentation given by Mickey Tripathi, of MAeHC and Rachel Block, Deputy Commissioner for Health IT of the NYS DOH. Let’s take them one at a time. I’ll deal with the first in this posting, and will save the second revelation for my next.
Despite the maturity of the HIT environment at Partners, and the depth of the resources they can draw upon; despite the fact that fully featured EMRs are not only deployed at all of their owned practices, but also at all of the affiliated physician practices in the Partners community health network (PCHN), even Partners acknowledged that they are not currently fully compliant with the stage 1 Meaningful Use criteria.
While efforts are underway to address the gaps identified, and they are confident that the gaps will be closed by 2011, what this analyst found notable was that here, even here, qualification for HITECH incentives is far from a foregone conclusion. With apologies to Bill Russell, you might say “it’s far from a slam dunk”. A cautionary tale for the rest of the country, to be sure, particularly in light of similar public statements by other leading provider organizations over the past several weeks, including Intermountain Health Care and Kaiser. If these storied organizations need to play “catch up”, what does this augur for the “middle America” of US healthcare organizations?
The presentation by Drs. Bates and Halamka focused on the areas identified in their respective organization’s gap analyses. As one would guess, the gaps were relatively narrow at their flagship sites. But there is more to Partners and to Care Group than Mass General, the Brigham and Beth Israel/Deaconess. Dr. Bates spoke about the wider gaps found at Faulkner Hospital, a Partners site located in Jamaica Plain, MA, about 4 miles from the heart of Boston’s “bed pan alley”. Faulkner is more representative of hospital-based healthcare in the rest of the US than the other iconic Boston institutions. It’s a 150-bed community hospital, running MEDITECH 5.6. The intent is not to single out MEDITECH – far from it – but with more than 30% of the US hospital market and the favorite vendor of community hospitals, if the gaps there are as large as was discussed here, what are the implications for the thousands of US community hospitals in the 50 – 200 bed range with minimal IT resources that are running products that are not compliant and where CPOE adoption rates hover near zero?
So let me hear your thoughts? Let me hear how ready you think your institution is today and whether you expect to be ready by 2011, 2012, later or never. Look for the revelation from Mickey Tripathi’s presentation in my next post.
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