
Will it happen?
I have my doubts, and they stem from more than fifteen years history
with the issue.
The key to the EHR and to any electronic data
interchange (EDI) is the general acceptance of standards. In the healthcare industry the standard format
is set as ASNA ASC X12 by a committee that includes all interested stakeholders
in the process. Reporting of data uses
standard sets for health procedures (CPT for medical and CDT for dental), diagnostic
grouping for why procedures might be performed (soon to be ICD-10 for medical
and dental and SNODENT for dental). Although
there are now accepted standards for reporting authorization, claims, and
payment electronically, there is no standard software at the operational level.
A huge number of the dental schools, including the
University of Tennessee, which I recently toured, use a system called axiUm, a Practice Management software
that has capability to measure the quality of outcomes and assist in defining
the effectiveness of treatment choices.
However, most of the schools do not use this capability and graduating students have no compatible Practice Management
software to use at the dental practice level.
Similarly, there are ongoing measures to standardize
medical data interchange. My
daughter-in-law is in training to be a certified Epic trainer, a choice she rightly feels will allow her to
capitalize on opportunities as the HER rolls out. Epic has the advantage of having developed a
system for use by patients as well as physicians and claims staff.

Current literature indicates similar lack of
embracement of the HER by physicians today, some of whom feel it is intrusion
in to their practice and others, that it is just one more time-consuming step
that detracts from patient care. From a
patient standpoint, my first-hand experience in attempting to retrieve my blood
studies electronically has run into compatibility problems from my email
service and privacy issues from the intermediary between my physician and
myself.

I find this hard to support when I see how the Centers
of Medicare and Medic aid Services contract across the public sector;
contracting with physicians, hospitals and medical device companies, setting
goals and incentives for efficiencies, and demanding common use of codes, diagnoses
and results.
I am hopeful that eventually reason will prevail and
there will be better interchange of information and standardization. If so, the ultimate winner will be the
patient and healthcare costs will be based on improvement rather than on
fee-for-service.
For many of us, time catches up with us, forcing us to
retract, support, or at the least rethink a position we have put into
print. In my next post I will share my
recent experience in such a case: in my case, my position on data
security. I think you will find it
interesting and perhaps enlightening.
No comments:
Post a Comment