Intermountain Healthcare's Marc Probst, Chief Information
Officer and Vice President of Information Systems, spoke to members of Congress
on November 14 at a hearing of the subcommittee on technology and innovation of
the House Committee on Science, Space, and Technology.
Below is a summary of his testimony. The full text is viewable at the Committee on Science, Space and Technology website:
Is 'Meaningful Use' Delivering Meaningful
An Examination of Health Information
Technology Standards and Interoperability Subcommittee on
Technology and Innovation of the Committee
on Science, Space and Technology
U.S. House of Representatives, November 14,
Summary of the
Testimony of Marc Probst, Chief Information Officer and Vice President of
Information Systems, Intermountain Healthcare
My name is Marc Probst, and I am the Chief Information
Officer and Vice President for Information Systems at Intermountain Healthcare,
a nonprofit integrated health system in Salt Lake City, Utah. I am also an
appointed member of the Health Information Technology Policy Committee (HITPC).
With respect to the first question posed in the
Subcommittee's letter, which asks what progress has been made as a result of
the HITECH Act towards greater health information technology (HIT)
interoperability, my answer is yes, progress has been made, but it is only a
beginning. We must set a clear road map and support an exchange infrastructure
and the adoption of standards that will make it easier to share health
information so clinicians and patients have the information in the form and
time they need it to make appropriate healthcare decisions. Presently, we lack
a shared infrastructure and long-term plan to make this possible.
The Australian railroad provides a useful example of the
importance of standards. In Australia, railroads developed independently, one
by one. While trains and tracks did get built, the railroad system was
constructed with many different gauges of rail, preventing railroad cars on one
set of tracks from running on others. After many years of subpar train service,
expensive work-arounds, and increasing costs, Australia defined a standard
gauge system. The process of standardizing the gauges was expensive and
disruptive, but efficiencies continue to be realized today.
There are parallels between the Australian railroad
experience and America’s HIT experience. On the HITPC, work began almost
immediately, and requirements were created with the goal to increase the
Meaningful Use of electronic health records (EHRs) across the country. The vast
majority of these Meaningful Use requirements deal with functions that an EHR
should be able to perform and requirements for what functions or data should be
shared between EHRs.
The existing HIT systems, be they vendor developed or
self-developed, also were built one-by-one and applied differing standards (the
great thing about healthcare standards is there are so many to choose from).
Although very effective for each institution, heroics are required to share
even basic data between them. We now essentially have our own Australian
railroad and fixing it will require leadership and investment.
The goals of ARRA and Meaningful Use of health
information technology (HIT) encourage acceleration of the adoption of
Electronic Health Record technology in our country. Meaningful Use and
certification requirements have started us down that road. The HITPC and ONC
have focused on leveraging available technologies to significantly advance the gathering
of digital data and incrementally introduce standards to support
interoperability. While continuing to support the current momentum created by
Meaningful Use, we must leverage all of the expertise in the federal government
to develop a long-range plan and architecture for a national healthcare
information technology infrastructure and outline the pathway to comprehensive
use of meaningful standards that facilitate national interoperability. This
will improve healthcare delivery quality, and significantly lower healthcare
costs. Successfully achieving that transition will also require significant
advanced planning, phasing and educational support of health
care providers as they change systems and workflows to
adopt the new standards.
I believe with true leadership and a commitment for
long-range planning and support for transitions, appropriate standards and
exchange infrastructure can be defined and implemented. If this is done,
innovation in HIT will skyrocket, costs for technology and access to knowledge
will be significantly reduced and quality care across the country will improve.