Information Week recently posted an interview with ONC's Dr. David Blumenthal that covers many topic. Dr. Blumenthal's comments on the ability of providers to participate in information exchange seems refreshingly on point. Massive national projects seem to come and go with little to show for the effort except time and money. This has made providers at the front line of health care reasonably skeptical. The electronic health record requirements in ARRA (the HITECH portion) elicit similar concern from smaller providers.
It is well known that larger providers, such as a Kaiser, have the resources in both money and staff to deploy highly complex and comprehensive systems. Smaller providers are left to look on in wonder. This is also true of the challenges faced by providers attempting to connect with information exchanges and the hurdles that exist with data formats, restrictions from the software vendor, and much more.
For this reason it is refreshing to hear that the Health IT Policy Committee has looked at this issue with some practicality. To quote from the interview Dr. Blumenthal said:
"At its last meeting the HIT Policy Committee adopted recommendations that they have not yet formally transmitted to me to encourage the development of a more flexible, adaptable, less complicated method of health information exchange than the Nationwide Health Information Network."
He goes on to say:
"We want to make sure what we do is develop exchange capabilities that are available to hospitals, physicians, nurses, and other health professionals who want to exchange information, and make sure they're practical and feasible to do without all the resources that big institutions have at their disposal. ...there may be a simpler way than a full NHIN to make that possible in the short term."
Dr. Blumenthal is careful not to suggest that NHINs will not continue to receive support. He mentioned multiple time within the interview that a full NHIN continues to have full commitment but that other approach are being considered.
"At the same time, the traditional, full NHIN remains a commitment of the Office of National Coordinator. We're thinking about whether there are compatible versions of the exchange that require varying levels of sophistication and resources to participate, and have varying levels of capabilities over time."
This seems like the right way to think about these challenges and I expect that most smaller providers will agree too often there is a disproportionate focus on what only the large organizations can accomplish. Health care is local and smaller providers continue to be at the front line of our health care system. What do you think about these efforts? Share your thoughts below... agree? disagree?