Is 'Meaningful Use' Meaningful? Marc Probst Speaks to Congress.

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 Results?

Is 'Meaningful Use' Delivering Meaningful Results?

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, 2012

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.