The Current State of National Health Information Technology

Minneapolis—The Affordable Care Act of 2010 places emphasis on the use of health information technology (HIT) and its potential to reduce healthcare costs and improve health outcomes. At a contemporary issues session at the AMCP meeting, Rachelle Spiro, RPh, FASCP, director of the Pharmacy e-HIT Collaborative, addressed the ways HIT will assist pharmacists to meet quality measurement goals for meaningful use of electronic health records (EHRs).

The session was titled Health Information Technology—A Landscape Update. Ms. Spiro began by explaining the difference between the electronic medical record (EMR) and the EHR. The EMR is the legal record created by a facility or physician’s office and is the source of the data for the EHR. EHR data will be shared with other healthcare entities such as hospitals, pharmacies, and laboratories. The components of the EMR must be defined and standardized to reach interoperability, she said. To exchange medication-related information, healthcare providers utilize a continuity of care document that includes information on allergies, a complete list of medications, immunization record, family medical history, social history (smoking, substance abuse issues), and functional status.

The Centers for Medicare & Medicaid Services (CMS) has incentives in place for meaningful use of EHRs that are available for eligible professionals and eligible hospitals. As of January 1, 2011, only physicians and hospitals are recognized as eligible to receive incentives for the adoption of the meaningful use of the EHR measurement concepts outlined by the healthcare reform law. Health Level Seven and the National Council of Prescription Drug Programs have developed a pharmacist/pharmacy provider EHR (PP-EHR) that was certified by the National Institute of Standards Technology and the Certification Commission for Healthcare Information Technology. Adoption of PP-EHRs may lead to HIT policymaker recognition, which in turn may lead to pharmacists being recognized as eligible professionals under the CMS rules, Ms. Spiro noted. She continued by listing ways pharmacists can have an impact on the long-term use of EHRs, including adoption of e-prescribing, adoption of the PP-EHR, and encouraging the bidirectional exchange of clinical information. Next, Ms. Spiro discussed barriers to full adoption of EHRs by pharmacists and pharmacies. The barriers include cost, regulations, uncertainty in the face of change, and a lack of awareness of the importance of EHR utilization. Benefits of adoption of EHRs listed by Ms. Spiro included care coordination, improvement in the quality of patient care, patient safety, and the recognition of pharmacists as eligible professionals.

The session concluded with an overview of the Pharmacy e-HIT Collaborative. The founding organizations of the collaborative were 9 professional pharmacy associations representing >250,000 members in all practice settings. The goals of the collaborative are to “assure the meaningful use of standardized EHRs that supports safe, efficient, and effective medication use, and continuity of care, and provides access to the patient care services of pharmacists and other members of the interdisciplinary patient care team,” and “to assure the pharmacist’s role of providing patient care services is integrated into the national HIT interoperable framework.” In summary, Ms. Spiro noted that there are “activities under way to develop the national HIT infrastructure,” and that pharmacy stakeholders are involved in efforts to support the consideration of pharmacists’ needs in that infrastructure.