Update on Modular EHR Technology: Harvard’s SMArt Research

DAVID C. KIBBE and BRIAN KLEPPER

ONC awarded four Strategic Health IT Advanced Research Project (SHARP) grants earlier this year to

”...address well-documented problems that have impeded adoption of health IT and to accelerate progress towards achieving nationwide meaningful use of health IT in support of a high-performing, learning health care system.” 

One of these grants was awarded to a Harvard group led by Drs. Ken Mandl and Isaac Kohane, based in Children's Hospital Boston and Harvard Medical School. This research team is tackling the problems associated with developing an ecosystem of modular, plug-and-play medical applications, what we have referred to as Clinical Groupware. (Disclosure: DCK is on the Harvard SHARP grant’s advisory board.) 

Beyond Meaningful Use: Three Five-Year Trends in the Uses of Patient Health Data and Clinical IT

by DAVID C. KIBBE and BRIAN KLEPPER

Finally, we have a Final Rule on the Medicare and Medicaid EHR incentive programs. The rules and criteria are simpler and more flexible, and the measures easier to compute. But they are still an “all or nothing” proposition for physicians, who will have to meet all of the objectives and measures to receive any incentive payment. Doctors who get three-quarters of the way there won’t receive a dime. And a lot of uncertainty remains about dependent processes that CMS and ONC must quickly put in place, like accreditation of “testing and certifying bodies,” and the testing schemas for certification. All in all, we expect most physicians in small practices to sit on the sidelines until the dust settles, likely in 2012 or 2013.