Report: Forging Ahead with Meaningful Use

In a keynote address to the attendees of the CHIME10 Fall Forum, David Blumenthal, M.D., the national coordinator for health information technology at the federal Office of the National Coordinator for Health Information Technology (ONC), told several hundred assembled healthcare CIOs on Wednesday that he remained optimistic that industry-wide progress forward under the ARRA-HITECH (the American Recovery and Reinvestment Act/Health Information Technology for Electronic and Clinical Health Act) legislation was proceeding apace, even as he acknowledged complexity and some confusion along the way.

Addressing approximately 650 members of the Ann Arbor, Mich.-based College of Health Information Management Executives (CHIME) at their annual autumn gathering , held this year at the Sheraton Wild Horse Pass Resort & Spa in suburban Phoenix, Blumenthal seemed careful to balance an overall sense of optimism about the path forward on meaningful use with a calculated willingness to challenge his audience.

“What’s next? We know that you have your hands full dealing with meaningful use, as it now presents itself; we know that a lot has happened in the past year,” Blumenthal told the CIOs. And, referring to a brief address by David Muntz, senior vice president and CIO of Baylor Health System, Dallas, that had been presented on video just before he was introduced, and in which Muntz had pointed to a large pile of papers on his desk that summarized the details of the meaningful use-related requirements that CIOs are facing, Blumenthal said, “We’re mindful of the stack of paper that David Muntz showed you from his desk; we’d like to shrink that stack of paper on your desks. But we know we can’t stand still as the clock ticks. So we would like to work with you. We want you to be participants in this discussion as we look to the future.”

In addition to fulsomely acknowledging the key role of CIOs in helping to lead their patient care organizations forward on MU, Blumenthal stressed four main areas in which ONC would push hardest going into Stages 2 and 3 of meaningful use under HITECH. First, he cited “robust information exchange. We envision a future where information follows patients, unconstrained by competitive rivalry, by geographic boundaries, by cultural disinclinations to collaborate,” he said. “We want teams to emerge in local communities that make exchange possible. And we will be using the meaningful use framework and all other levers at our disposal to make that possible. “

Second, Blumenthal emphasized advanced clinical decision support as one of the key elements to be more fully elaborated in MU requirements in Stages 2 and 3 of MU. In that context, he emphasized that advanced clinical decision support will be “a teaching tool, as well as something to correct perhaps inappropriate ordering.” Third, he said, “We’re also going to be engaging in a separate, related, parallel discussion about what health information exchange means, and how to support it. The technical and policy requirements that will make it possible to be effective at a local level, in terms of information exchange, are yet to be [seen]. The question of what the architecture of our nationwide health information network should look like, should be discussed in the next six to eight months, in terms of how data should be stored and protected,” he added. And, fourth, he said, it will be necessary for all the stakeholder groups in healthcare to engage in an industry-wide discussion of patient data privacy and security issues. “The discussion” around privacy and security, Blumenthal said, “will be loud and at times trying. But it is a necessary discussion, and we will have to take it on, because we owe you, owe the states, owe the vendor industry, our best thinking about what the best practices should be. “

In responses to audience questions, Blumenthal noted that, while he and his colleagues could not legally release information about the Stages 2 and 3 requirements under meaningful use outside the formal process of publishing preliminary and final rules, he would do his best to telegraph ONC’s overall intentions whenever possible. He was in the middle of responding to a question regarding HIE when the hotel’s fire alarms went off, prematurely cutting short the Q&A session. Concluding quickly over the sound of alarms, Blumenthal thanked his audience, and received polite applause from the assembled CIOs.