Hold Onto Your Hat

Vince Kuraitis at the e-CareManagement blog has done a great job of relating some big picture issues regarding the “meaningful use” transformation that is imminent. I invite everyone to review Overview: Here Come Stages 2 and 3 of HITECH!
I think it is especially important to notice how low the bar is set to meet stage 1 of “meaningful use” when this is compared to stages 2 and 3.
It is my opinion that few to no EMR vendors have articulated even a plan for a path to stages 2 and 3 that is either practical or affordable. Most of the current generation of simple, or “paper behind glass” EMR products primarily being sold to independent physician practices, and most of the current generation of comprehensive EMR products being sold to enterprises are not likely to prove to be viable solutions beyond stage 1 without major rewrites of their software and a radical change in their business models. This promises to be a major burden that most physicians now using EMR products will have to somehow manage at the same time that major shifts will be taking place in how payments for healthcare services are taking place.
Equally enlightening is Vince’s essay discussing the differences between data interoperability and workflow interoperability- Geek Wisdom: “Interoperability” Must Include Process Collaboration.
IMHO, the most important themes he so well articulates are that having the technical ability to exchange information is of little value unless the more challenging issues related to workflow interoperability are addressed. None of the interoperability projects I have reviewed to date seem to understand just how critical this is. The greatest successes in the future will go to the entities that begin to understand and address this issue sooner rather than later.