PDF: Key HIT Terms, Definitions and Characteristics (nahit.org)

The answer to the question, of course, is a lot. I sat in on a Definitions Forum held today in Washington, DC, to review work in progress around defining and characterizing key HIT terms. These include ones we use and see a lot: EHR, EMR, PHR, RHIO and HIE.

I sensed from the experience that there is potentially (potentially) much at stake in the definition of these terms, because definitions reflect culture. Indeed, Dr. Karen Bell, who opened the session stated that “culture eats technology for lunch.” In my own work, I have learned something similar - “culture eats strategy for lunch.”

Even though the acronym “PHR” is discussed at the beginning of the presentation, the discussion centered mostly on RHIO, HIE, and EHR, and I focused my attention mostly on the last acronym. What I appreciated about the emerging definition of EHR (see page 20 of the presentation) is that it is more aspirational than I have seen in the past. Still, there was some interesting discussion on two specific topics. One, the role of health plan as an actor in collecting and accessing data from an electronic health record. I stated in the discussion that this connection requires further discussion, in my opinion. At the current time, the definition says “collected from and accessible by all providers.”

I think a bigger issue is the role of the patient in the definition. It’s not there. This was brought up, and our moderator, Dr. David Longnecker from the Association of American Medical Colleges, posed an interesting question about this. He wondered if adding patient input to the EHR was similar to listserv’s he has operated where the moderated variety have been more successful than the unmoderated variety. This was a great time to add the experience of Group Health Cooperative, which has shown that patients are very respectful of their care team and of their health record, even now that they are allowed to write to it via the online health appraisal.

Comments (rather than definitions) are still being accepted through the Web site, at this link. The definitions are set to be completed on March 28, 2008.

This is my iPhone 1.1.3 edition blog post. The upgrade went flawlessly. I think this is a good time to reflect on how things are going in terms of being my own CIO. Green light here. I think technology is lightweight and standards based enough that it is enjoyable to e-mail, calendar, and content manage with a few simple tools that sync well with each other, in fixed locations and on the go. The software lineup I mentioned in my first post has not changed - it has only gotten better. Data detectors in Leopard work amazingly well and are a huge time saver. I recalled about 2 years ago that I could look down at my Macintosh dock and find all 4 Microsoft Office apps running on it. Since this experience, there usually aren’t any, as they have been handily replaced by Mail, Pages, Numbers, and Keynote. This is not to say that I have a goal of replacing Microsoft apps on my desktop. I am really looking forward to purchasing Office 2008 and seeing what it has to offer. The Macintosh Business Unit there always does a great job with their products and are a good example of the benefit of having an in house innovation unit.

All of that aside, the next question for me has to be - how to get this lightweight technology into the enterprise, because this is what people are learning outside of work. Why not make it what they use at work? What is the cost of acquiring and supporting the monolithic suite of applications that most enterprises use? This is especially relevant for the next generation of leaders and staff (GenX and Y). Are there examples of CIO’s out there who are pioneering in this regard. Worthy of exploration…

Links for January 14-15:

• Flickr DNA: Discover someone new. Rediscover someone anew. - Another interesting social networking app based on Flickr
• flickr graph - marcos weskamp - A great visualization of a social network, this time using Flickr. This could be very useful in the enterprise - “Who is good at X?”
• The 2007 Medical Weblog Awards Nominees - Medgadget - www.medgadget.com - As the title says. The ranks are growing bigger…
• Is Enterprise 2.0 Bad for Business? - Yahoo! News - Lotus Notes the same as a Wiki? I don’t tihnk so….the issue is about lightweight technology that’s standards based and easy to deploy. This is what the enterprise needs.
• Report: EMI Records To Cut Workforce By 36% -
• Health Beat: Who Decides How Much Specialists Are Paid? - Historical commentary on RBRVS and its update committee. It would be interesting to see possible solutions proposed to support a more patient-centered health care world.
• PR Newswire - Healthcare/Hospitals News - Regence members in the Pacific Northwest to be able to provide feedback on their experience with providers to each other. Does this need to sit within the health plan’s web site, though?
• Report lauds VA’s focus on quality care, health IT -