You can say this about Dr. David Blumenthal: He is certainly passionate about his work and his belief that information technology can transform health care.
Delivering the keynote this morning, Blumenthal didn’t really break new ground. Those who expected him to hand out advanced copies of the definition of meaningful use—well, they were disappointed. In fact, he let it be known early on during his address that no such notice would be forthcoming today. We’ll just have to wait like the rest of the world for a proposed rule to show up in the Federal Register, hopefully before year’s end.
That’s not to say that he didn’t provide some tea leaves for people to read. Blumenthal emphasized that the rulemaking is focused on three areas, as required by law: e-prescribing, information exchange and quality reporting. He also referred several times to the importance privacy and security will play. In terms of other applications, such as personal health records or CPOE, he suggested that people take a look at the matrix from the Health IT Policy committee, which advises his office.
Another central idea, he said, is that meaningful use will get more stringent over time. So, the requirements in year 4 will be more demanding than in year 1. Interestingly, Blumenthal said he’s been talking with credentialing boards and medical societies about how they measure core competency for physicians. Eventually, he believes IT know-how will be factored in.
Blumenthal worried, like many in the room, that a workforce shortage could hamper IT adoption. Some estimates, he said, suggest a shortage of 40,000 to 100,000 IT workers. His office puts it somewhere in the middle, maybe around 50,000. What’s needed are not just technicians, he said, but a new breed of IT worker. They need to have interpersonal skills to communicate with docs who are reticent to try the new tools, they need to help in workflow redesign, and more.
That, in fact, was a key theme in his remarks: This isn’t about technology. It’s about using the technology to fundamentally change the way health care is delivered. It’s about putting the patient first.
A couple of other thoughts on his speech:
• Just this week, he asked the policy committee to look at a growing privacy issue: Patients wanting to put access restrictions on their records, or parts of their records. How does that mesh with the needs of clinicians and administrators to get valuable information they need to make information exchange successful?
• The law only focuses on hospitals and physicians; there’s no money for or mention of post-acute settings—yet everyone involved knows that they need to be part of the process. He hopes Congress will eventually address that, or that the market will bring these providers along.
Matthew Weinstock, senior editor, H&HN, is blogging live from CHIME 2009.
