How close are we to meeting the promise of electronic health records?

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Photo: Carla K. JohnsonA panel of experts discusses health information technology at an AHCJ Chicago chapter event on March 3 in Chicago. From left: Dr. Arnold “Ned” Wagner Jr., chief medical information officer, NorthShore University HealthSystem; Dr. Diane Bradley, senior vice president, chief quality and outcomes officer, Allscripts; Eric Yablonka, vice president and chief information officer, University of Chicago Medicine; and moderator Neil Versel, an independent journalist.
Photo: Carla K. JohnsonA panel of experts discuss health information technology at an AHCJ Chicago chapter event on March 3 in Chicago. From left: Dr. Arnold “Ned” Wagner Jr., chief medical information officer, NorthShore University HealthSystem; Dr. Diane Bradley, senior vice president, chief quality and outcomes officer, Allscripts; Eric Yablonka, vice president and chief information officer, University of Chicago Medicine; and moderator Neil Versel, an independent journalist.

Yes, technology is transforming health care. No, we haven’t come anywhere close to realizing the vision.

Smooth patient handoffs, data-driven performance improvement and real-time analytics are still mostly dreams, although those ambitions have been talked about for years.

Independent journalist Neil Versel, who specializes in health information technology, moderated a panel on March 3. The AHCJ Chicago chapter event was held at AMA Plaza, the new headquarters of the American Medical Association.

Electronic medical record systems “need to play nicer together so they can use each other’s information as if it was natively generated,” said Arnold “Ned” Wagner Jr., M.D., chief medical information officer of NorthShore University HealthSystem. “Can we talk to each other transparently? Well, partly. The success of communication depends on human behavior and (technology’s) job is to help understand the reality of what motivates people to do things.”

Eric Yablonka, vice president and chief information officer for University of Chicago Medicine, described the challenges of meeting federal “meaningful use” requirements. Compliance can mean millions of dollars to hospitals, but checking all the boxes can be difficult for physicians. Nobody’s sure yet of the ultimate effectiveness of the government incentives and penalties, Yablonka said, but the program has led to a more “rapid adoption of electronic systems in health care” that wouldn’t have happened otherwise.

Innovations often come from the field, said Diane Bradley, M.D., Allscripts’ senior vice president and chief quality and outcomes officer. She described how hospitals have developed custom software that has later been adapted for broader use by her company. “We’re never going to be as agile as the young developers out there,” Bradley said.

Physicians have mostly put down their pens and adapted to electronic records, Wagner said. But expect the next phase to be shaped by incremental changes, rather than sudden leaps. “We’re going to have an evolution, rather than a revolution.”

Before the discussion, AMA CEO James L. Madara, M.D., led a tour of the 47th floor of AMA Plaza, architect Ludwig Mies van der Rohe’s last American building (formerly known as the IBM Building). One display case holds relics of health fraud and quackery, including tonics, radioactive glasses and the “Orgone Energy Accumulator,” a 1942 device sold as a cure for everything from cancer to impotence. Will our electronic systems of today someday look as quaint and naïve to us? Stay tuned.