Wall Street Journal Examines Blumenthal’s Anticipation of ‘Huge Challenges’ as Head of National Health IT Office

Former Harvard Medical School professor David Blumenthal, who this week assumes his new role as head of the Office of the National Coordinator for Health Information Technology at HHS, anticipates difficulties in efforts to establish a national electronic health records system, the Wall Street Journal reports. In a recent New England Journal of Medicine article, Blumenthal wrote that he expects to encounter "huge challenges," including low adoption rates for the technology, high initial set-up costs, potential technical problems and data privacy concerns among physicians and patients.

Blumenthal and other supporters of health IT have said that EHRs can improve health care delivery, reduce costs and boost the quality of care. An interoperable system between physicians' clinics, hospitals and public agencies also could reduce the risk of medical errors by providing alerts them about dangerous medication interactions. However, some experts warn that poorly designed or poorly managed systems could increase the risks for patients because of insufficient public oversight of the systems, the Journal reports.

Blumenthal said that issues with EHRs can arise if users try to install them too quickly without adequate technical support, which he noted is a "critical factor" in reducing the risks. David Collins of the Healthcare Information and Management Systems Society said some risks associated with EHRs are created by how they are installed and how an office's staff is trained. Collins said, "It's not plug and play. It's not like going to Best Buy and getting Windows."

Up To Blumenthal
The economic stimulus package signed into law in February included $17 billion in incentive payments for physicians and hospitals that adopt EHR systems. Beginning in 2015, the law would levy penalties on those that have not yet installed EHR systems. The bill states that physicians and hospitals must use "certified" EHR systems to be eligible for the payments. According to the Journal, it will "fall largely" on Blumenthal to establish the certification criteria.

The Certification Commission for Healthcare IT currently certifies EHR systems now available on the market, based on whether they are interoperable and have certain functions. However, Blumenthal said that having certain functions is not enough. He added, "We need to ensure that physicians can actually use it." CCHIT Chair Mark Leavitt said the group is considering a revision of the certification criteria to include users' experiences.

According to the Journal, the stimulus bill does not indicate whether CCHIT will be responsible for providing EHR certification. Blumenthal declined to comment on the group's role in the system certification process. Leavitt said that the group would consider modifying its certification process (Goldstein, Wall Street Journal, 4/21).