ONC is More Focused on HIE than EMR

I can’t remember where I heard or read this, but I remember that when I did it stuck with me and I knew I had to write about it. Here’s the comment someone made (sorry I can’t attribute it properly):

Frankly, ONC is more focused on info exchange than EMR in the long run.

That’s a pretty strong statement, and one I really can’t argue against. In fact, if ONC didn’t have $36 billion out there hanging on the terms meaningful use of a certified EHR, they’d probably be doing even more with HIE and less with EHR.

I think ONC should actually be applauded for many of the health information exchange initiatives that it’s been pushing forward. I think that the Direct Project (which I broadly include in health information exchange) is one of the most exciting things in healthcare exchange right now and ONC should take a lot of credit for making it happen. I’m still waiting for my friends who happen to be physicians to talk to me about using direct project. Then, I’ll know it’s really gone mainstream, but I think it shows such promise that one day they will be telling me about it.

Yes, as most of you know, I still somewhat begrudgingly wish that the EHR incentive money would have gone towards exchange of healthcare information instead of EHR. It would have incentivized something that doesn’t have natural physician incentives to adopt. Plus, an EHR would have been essential to really exchanging information if the “healthcare data exchange stimulus” money was executed properly. Then, market dynamics would determine EHR adoption to a much larger extent. Water under a bridge it seems, but maybe someone at ONC could scrape some money together to prove me wrong.

With all of that said, I think ONC wants the healthcare information flowing. They see EHR as a step towards that end, but that’s the end goal. We’ll just see if they have the tools and resources needed to see it through a midst all the other healthcare IT distractions.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • I thought HIE was the real impetus behind the EMR revolution. Keeping lab and radiology data easily accessible to all physicians who might be treating a given patient.
    Once you get “easily accessible” in place, HIPAA goes out the window or “easily accessible” becomes impossibly complicated and virtually unusable.
    Then we come to the electronic record, which could be printed to pdf and sent electronically to satisfy an insuror, govt payer or regulator—-as well as another care giver. Incorporated into the electronic record were all sorts of schemes to give “added value.”
    I have not seen HIE really work in the suburban Washington, DC healthcare community.

    Maybe it is just an expensive fad.
    I used word-processing notes in a book-keeping computer system in my office for roughly ten years. For pre-op notes, the surgical center or hospital loved it. It was legible and organized with everything (including some old lab studies) there. But this was not the “EMR” system envisioned by many. It was developed by a computer guy who went to medical school and saw places where he could use IT to help for his own office.
    Maybe it is just an expensive fad.

  • What an interesting description. I wonder if easily accessible and HIPAA security are so counter to each other that we’ll have achieve “data easily accessible to all physicians who might be treating a given patient”

  • I take a different view, but no less agree that health information exchange should have had a greater focus at the outset of the HITECH Act. But, hindsight is always 20-20. Hospitals, and, in some cases, even providers have been using health information technology for years, but not necessarily comprehensive EHR’s. A focus on developing community-based HIE’s and the active movement of providers (hospitals and physicians) towards health information exchange as a practical activity of care delivery would have had the ultimate effect of supporting EHR adoption, but only as it fits into the clinician workflow of care delivery. I do think ‘adjust in flight’ considerations are needed if we are going to reach the end goals envisioned in the HITECH Act.

  • The topic of this post is HIE more a focus to ONC than EHR.
    My, slightly sarcastic, response to that is: the more information “they” have on us, the more power they have over us. They could be Google, Apple, MS, or quite simply the U.S. Government.

    To DocJim’s statement – that is right on spot. In our world of law suits, who would want to risk writing the system that is to store some of peoples most personal information?
    Make access easy (like FB) and it is way too easy to phish your login credentials.

    Make access reasonably secure and people won’t want to deal with that hassle…YET they’ll be glad to sue when someone breaks into their easier-to-use system.

    Short story: my folks are in Paris. They just called me via cell phone to look up the ATT access number, then they wanted me to email to them. They have their iPad with them.

    Yes, you are correct, that means they could have looked this up on their iPad.

    This is the tech level of most people we have to be so careful how the access to medical records online is handled.

  • Hmmm…I don’t follow that ONC just wants our data. Those that I’ve met at ONC aren’t approaching it in that manner at all. Plus, from what I’ve seen, they won’t know what to do with the information if they get it. Which also illustrates that they’re not worried about trying to get that data for other purposes.

  • This may be viewed as conspiratorial, but there is no denying that Google/Facebook et al want our data.

    It is of huge value to them.
    Yet, most end users don’t see it that way.

    On the “big brother” government side, again, the data is of huge value, whether that is for research or cutting off medical coverage is yet to be seen.

    The worker-bees at Goog/FB are just coding to make the “experience better”. It is the highest levels that sit around and figure out what data they gather and how to use it to generate revenue.

    So, why would we think the gov bureaucrat worker-bees would have a deep view as to the plan for this data beyond making the health care experience better?

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