2010 will be the year of health record implementation

In their excellent review of 2009 trends at The Health Care Blog, David Kibbe (below) and Brian Klepper (right) note that key decisions on Electronic Health Records (EHRs) were made this year, making 2010 a big year for implementation.

Both are modest regarding their own roles in this. But they have been key advocates for these changes (or something like them), and have applauded most of them along their way.

1. Stimulus money will flow based on making use of EHRs, not just for EHR software and hardware.
2. EHR advocates now face hard questions relating their gear to gains in productivity and quality.
3. The CCHIT, a product of the HIMSS industry group, no longer has control over the choices hospitals and clinics have.
4. Power is slowly moving from EHR "experts" like McKesson and Epic toward general technology firms like Microsoft.

Here are just some of the implications:

1. There is going to be a gold rush. Hospitals and clinics are going to turn from Lookie Lous to serious buyers in 2010.
2. Expect some big mergers as firms like H-P and Dell seek credibility with this market, buying the best of the mainline firms.
3. The focus on productivity means we're going to see a lot of "case studies" focused on using EHR data to drive change in medical practice.
4. There is going to be a lot of job growth throughout the sector.

The National Coordinator for Health IT, David Blumenthal, set us up for the last by putting $80 million into training the EHR shock troops, who should start emerging from community colleges in the next year.

My guess is most of the new graduates will wind up on the "buy" side of the EHR table. They are going to be tasked with making all this stuff work, under the guidance of "sell" side EHR experts trained during the last decade and business school graduates focused on results.

Those results will be driven by the beacon communities on whom Blumenthal's office will bestow $235 million starting early next year. The big news of 2010 will probably be made in February, when the money is doled out and we get to see what the Administration defines as excellence.

And don't forget. This still leaves over $18 billion unaccounted for, money that will start to flow during the year as hospitals and clinics achieve the 2011 "meaningful use" goals.

There are going to be a host of stories flowing out of those beacon community grants. Here is one example.

Will those being honored in February still be on the job in May, or will they quickly be hired away by vendors eager to know "the secret" to getting stimulus cash? That could be disastrous, because the beacon communities won't be getting honored for what they have done, but will be getting incentives to do more.

At the end of 2009 we know what the game is. The game is not to install EHR systems, as was believed at the start of the year. The game is to prove value from them, getting ideas we can use to drive down costs and change the system.

That's what we'll be looking for next year, too.

UPDATE: While I was writing this Microsoft announced it is buying Sentillion, which works at moving EHR data from proprietary systems to the Web. The merger gold rush has already begun!