Stimulus Funds Include Physician Incentives (and Penalties) to Encourage EMR Adoption
The Conundrum of Physician Adoption of HIT, Health Information Exchanges (HIEs) and Stimulus Funding

AMA Meeting Next Week to Discuss ARRA and Health Information Exchanges (HIEs); Physicians Need to Maintain Ownership of Patient Health Information

The American Medical Association (AMA) is meeting in Chicago next week to discuss President Obama's federal econonomic stimulus package (ARRA) as it relates to the healthcare industry.  The Department of Human Services will have representatives present.  The Texas Medical Association and other state medical societies will concurrently participate in peer-to-peer meetings to discuss the role that state medical societies can and should have regarding the health information technology incentives and the health information exchange (HIE) infrastructure.  In order for physicians to gain value from implementing ambulatory EMRs, there must be an infrastructure (and policies/procedures) in place that allows patient information to be accessible whenever and wherever it is needed.  This infrastructure will succeed only if it garners the public's trust that the privacy of their health information will be maintained.  It is my belief that the public is far more likely to trust their local doctor with private health information than they will any government entity or other anonymous public-private HIE entity.  Local doctors typically are members of their local county medical society, and these county medical societies roll up to the state's medical association, such as the Texas Medical Assoication.  One strategy is to allow local physicians to maintain "ownership" of private health data by having their county medical society establish a community data repository.  The physician's medical society would become "the owner" of the data, protecting the patient's privacy while providing appropriate access to providers who need the data to provide high quality care during patient encounters.   This idea has surfaced in the state medical association arena.  As digitized patient health information becomes more prevalent and therefore more valuable to exchange, the financial difficulties HIEs encounter today will wane.  At that point garnering and maintaining public trust will become a primary challenge for HIE sustainability.  Leaving ownership of private health information data repositories to the providers is one way to achieve public trust.  It will be interesting to follow up with state medical associations following next week's meetings concerning the state and national HIE infrastructure strategies.  



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