This week's Journal of the American Medical Association includes two commentary articles that propose strategies for moving forward with national electronic health record adoption.
EHR Monitoring and Evaluation Framework
Dean Sittig of the University of Texas School of Health Information Sciences and David Classen of the University of Utah School of Medicine write that policymakers should establish a comprehensive EHR monitoring framework to ensure the safe and effective use of EHRs.
The authors propose that this framework would include:
- Mechanisms for health care providers to report EHR-related adverse events;
- Enhanced certification processes that support EHR safety goals;
- Self-assessment guides for health care providers and other EHR users;
- Onsite accreditation of EHR safety; and
- A national investigation board for EHR-related adverse events.
The authors suggest that this framework could "begin to provide the oversight needed to ensure that all EHR implementations are safe and effective and to provide the mechanisms to help health care organizations using these systems to deliver the highest quality, lowest cost and safest health care possible" (Sittig/Classen, Journal of the American Medical Association, 2/3).
EHRs in the Age of Social Networks
Aviv Shachak and Alejandro Jadad of the University of Toronto's Department of Health Policy, Management and Evaluation write that emerging social networking tools and other digital technologies provide policymakers with a unique opportunity to re-envision an interconnected EHR system.
The authors suggest that this innovative new EHR system could tap into:
- Tools that promote patient engagement in health care;
- Standards allowing for interoperable health data exchange;
- Audio, video and other multimedia narrative tools;
- Videoconferencing and other online communication channels;
- Health-specific social networking tools;
- System-wide data aggregation mechanisms; and
- Strategies for achieving balance between transparency and patient privacy.
The authors conclude that these suggestions could help EHR systems "produce the savings that the Obama administration hopes to achieve through the reduction of waste and abuse, while meeting the expectations and needs of the public at no extra cost" (Shachak/Jadad, Journal of the American Medical Association, 2/3).