Looking Back At A 2014: Thermidor For Health Care Reform?

Andy Oram | EMR & EHR | December 29, 2014

As money drains out of health care reform, there are indications that the impetus for change is receding as well. Yet some bright spots in health IT remain, so it’s not yet time to announce a Thermidor–the moment when a revolution is reversed and its leaders put to the guillotine. Let’s look back a bit at what went right and wrong in 2014.

Although I want to focus on the IT aspects of health reform, we must acknowledge important advances on the policy front: the groundswell of sign-ups for health insurance among those who would otherwise be uninsured, and the slow-down in the rise of health care costs, however temporary that may be. One can find plenty of pessimistic news reports to balance these successes, but they remain worthy of notice.  The FHIR standard for open APIs, whose significance I covered a couple months ago, has not only been blessed by the ONC but, more importantly, has won promises from all the major U.S. EHR vendors to implement it.

Again, our joy this season must not lose its sobriety. The vendors will probably take their time implementing FHIR. If they introduce arbitrary barriers, as they have done with the open Direct project, we may be in for another exhausting round of struggle for interoperability. Meanwhile, tools to extract, interpret, and make use of the data from FHIR will have to evolve before it can have an impact on clinicians’ behavior and bottom lines...