Agency seeks uniform way to gauge e-health progress

The nation's health department is angling to find out just how fast America is working to adopt health information technology.

The government currently has a patchwork of data gleaned from disparate studies with mismatching definitions of key criteria like "electronic record." After realizing that there is no single approach for calculating the percentage of health care providers using electronic health records, the Health and Human Services Department on Wednesday awarded a contract to measure the adoption of health IT.

"The goal is not to promote, advance or in any way influence the short-term health IT adoption," David Brailer, the department's health IT coordinator, said in a Wednesday conference call. Instead, the department aims to measure whether federal and state policies have changed "the dynamics of health care."

The winners of the contract, George Washington and Harvard universities, will seek to develop mechanisms for analyzing disparate indicators of e-health implementation. Brailer compared the work with the White House Council of Economic Advisors objectively analyzing economic indicators for the president.

The universities plan to appoint a panel of 15 independent experts to determine how to harmonize the different terminologies and concepts of 10 or more key studies. The panel will "create standards of what constitutes reliable information" found in available surveys, said David Blumenthal, a healthcare policy professor at Harvard. He will lead a team with Sara Rosenbaum, a health law professor at George Washington.

"We want to raise the IQ and the bar of all the surveys out there," Brailer said.

One such study that will feed into the universities' research was released earlier this month by the American Hospital Association.

In a study of more than 900 hospitals, the hospital group found that 92 percent were considering using or testing health IT for clinical purposes. The remaining 8 percent primarily were located in rural or small hospitals.

Technologies that go beyond the e-health records also are being implemented or used at more than half of the hospitals surveyed. The tools include bar-coding, telemedicine and radio-frequency identification technology. More than 50 percent of respondents use bar codes on laboratory specimens, while 37 percent use them for patient identification and 30 percent for tracking pharmaceuticals, the study found.

But there are discrepancies among survey definitions. The hospital association's study referred to an "electronic health record." But another study may call the same tool a "personal health record," and a third group may define it as an "electronic medical record." Additionally, the attributes of each may vary. The panel will focus on the function rather than the branding, Brailer said.

"This [approach] will help us shed light on not only the diffusion of electronic health-record technology" but also will update the lexicon of medical records, Rosenbaum said.

The panel is scheduled to issue its first annual report next fall. The reports will serve as long-term indicators of how practitioners and hospitals are meeting President Bush's goal of the widespread adoption of e-health records by 2014. The monetary figure of the award has not been publicly disclosed, Brailer said.