Monday, April 25, 2016

Too Late: ONC EHR Comparison Shopping Tools

This article from Healthcare IT News, "ONC offers 4 ways to build better EHR comparison shopping tools" highlights why ONC is becoming less and less relevant.

Simple Yelp ratings would be more effective than a bureaucratic rating system that was mandated by Congress and managed by ONC... but I think it's a little too late anyway, no? ONC and HITECH already doled out $30B of our tax money to create a false market demand and incentivize the acquisition of products that are generally considered frustrating to use, at best, infuriating to use for many physicians. The horse is already in the garden and the crop is stomped. The best that the ONC can do now is plant a new garden-- start focusing on and encouraging the development of next generation EHRs and clinical decision support systems so that in 8-10 years, when our hangover from the HITECH investments has worn off, there will be a crop of new products and technology that attract clinicians naturally to their use, no federally subsidized incentives needed.

In the meantime, ONC could also play a critical role in the development of data governance strategies for patient reported outcomes, healthcare cost accounting, the social determinants of health, familial history, clinical decision support algorithms, and clinical interoperability that is data-centric, not document centric. The data in today's crop of EHRs only accounts for 10%* of the data required for both population health as well as precision medicine (*--Alberta Secondary Use Data Project, 2015) and 0% of the clinical decision support that machine learning could provide.

ONC needs to salvage its value by jettisoning its current mindset and focus on today's EHRs-- that train left the station. It's time to look ahead, and with a new leadership at ONC under Kathleen Blake, no time is better than now.

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