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Sequel Systems Responds to the June 16, 2009 Meaningful Use Recommendations

June 16, 2009

In the words of David Blumenthal, M.D., the national coordinator for health information technology, "this is the beginning of a conversation that will continue for some time," adding that "there is a long way to go" before a final definition of meaningful use is achieved.

Sequel Systems supports Dr. Blumenthal’s sentiments and the Meaningful Use Workgroup’s initial recommendations to the HIT Policy Committee towards the realization of a formal definition of “meaningful use”. The key goals postulated in the initial recommendations released on June 16, 2009 visà- vis a three-page preamble to the report and a well-defined, simple to understand matrix are:

Improve quality, safety, efficiency, and reduce health disparities Engage patients and their families Improve care coordination Improve population and public health Ensure privacy and security protections for personal health information

Although it is a daunting and complex endeavor to define “meaningful use,” the Workgroup has clearly developed the foundation of an inspiring and comprehensive definition that sets the groundwork for a tangible and substantial vision of transforming health care delivery while highlighting that this is a progressive undertaking focused on results and not merely an exercise in software implementation.

“The ultimate vision is one in which all patients are fully engaged in their healthcare, providers have real-time access to all medical information and tools to help ensure the quality and safety of the care provided while also affording improved access and elimination of health care disparities. This ‘north star’ must guide our key policy objectives, the advanced care processes needed to achieve them, and lastly, the specific use of information technology that will enable the desired outcomes, and our ability to monitor them.”

Of course, technology will play a tremendous role in the realization of this vision and Sequel Systems applauds the Workgroup’s early call for adoption of electronic health records (EHRs) and computerized physician order entry (CPOE), including time and cost-saving features such as electronic transmission of permissible prescriptions and incorporation of lab-test results into EHRs. Sequel Systems is fully prepared to provide the technological means through its SequelMed EHR and associated product functionalities to expedite the fulfillment of objectives and measures outlined by the Workgroup. Furthermore, the implementation strategy deployed by Sequel Systems—a tiered or phased approach whereby users are steadily acclimated to EHR processes—coincides with the gradual adoption methodology outlined by the Workgroup.

Indeed, Sequel Systems’ successful customer implementation experience proves that those users who started utilizing EHRs early on not only have had the luxury of implementation time on their side, but also have improved their workflows and quality of patient care in a progressively “meaningful” manner while benefitting from advances in technology along the way. At the end of the day, no matter how technologically and functionally advanced a product may be, service and support are critical in overall adaptability, transition, implementation and continued success. We believe that sound implementation strategies with emphasis on an “evolutionary” versus “revolutionary” approach—keeping in mind the diverse needs of users, whether small practices and clinics or large hospitals and organizations—will be the cornerstone of meaningful EHR adoption.

While the Workgroup has underscored the involvement of professional health care teams and communication with public health agencies to improve care coordination and population outcomes, we feel that it is imperative also to engage external entities such as lab companies, diagnostic centers, pharmaceutical companies, home health care and nursing facilities in a "meaningful" manner to ensure that exchange of health information and interoperability is facilitated accurately and comprehensively.

In addition, the role of information networks is vital in improving communication among health care organizations. An information and communications infrastructure is critical as many avoidable errors and poor outcomes can be attributed to inaccessible data, lack of properly documented information and inability of agencies to share critical information in a secure and timely manner. Therefore, coordination, integration and overall management of clinical information across localities/regions and providers of care is critical if any health care information technology initiative is to succeed.

Sequel Systems recognizes that the Workgroup has a challenging task ahead. Many have and will continue to raise myriad concerns, whether from a technology, privacy or security point of view. However, as stated by Dr. Blumenthal, “it is a journey we must take if we are to improve care through the use of EHRs.” Ultimately, whether we are for it or against it or somewhere in the middle, it cannot be denied that this is a positive step on the road to EHR adoption, especially given that the health care information management arena has been relatively slow in catching up to technology. With initiatives such as those undertaken by the ONC under the auspices of ARRA, physicians and others in the health care industry are starting to see the positive impact that information technology has had on other industries and are ready to utilize technology as a tool themselves. As we progress towards the ultimate vision, utilizing technological advances to provide secure, timely and logically organized access to clinical information will become more realistic and imperative. We applaud the Workgroup’s efforts and look forward to its second version of “meaningful use” definitions due at the next HIT Policy Committee meeting on July 16th

For more information, please contact Irfan Iqbal, Director of Medical Informatics at iiqbal@sequelmed.com or 631.694.3600.

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