Kevin DeWald, South Dakota’s Department of Health HIPAA compliance officer and senior director of the South Dakota eHealth Collaborative, coms to tell us about health information technology and the efforts South Dakota is making in this growing field.

DeWald cites the 98,000 stat: 98K deaths due to medical error… many of them from bad penmanship! Paper kills! There are also 7,000 deaths from medication errors, a million plus illnesses from medication error.

To get us to fully electronic medical records by 2014 (remember, that’s the date Pres. Bush set in 2004), we’ll 70,000 new health IT workers (DSU’s going to need another building).

Tech beats paper for privacy/security! A piece of paper is the easiest kind of record to break into! Anyone can read it, no software required.

DeWald refers to the American Recovery and Reinvestment Act (this year’s stimulus act) as a “game-changer” for health IT, not just in terms of funding but also new provisions on privacy/security. (Holy cow: ARRA includes an open source study: The law requires by no later than Oct. 10, 2010, the completion of a study that examines the availability of open source health IT systems; the total cost of ownership of these types of systems, compared to proprietary commercial products; and capacity of open source systems to facilitate interoperability” !!!)

DeWald says SD is slightly ahead on EMR adoption, since we are a smaller state with many providers connected to three major health systems; currently 85% of our population may be covered by some sort of EMR system.

Geographic and technological disparities are a challenge for us: just 2 urban counties; the remaining 64 are split between rural and frontier (sometimes defined as 6 or fewer people per square mile… but your mileage may vary)

DeWald thinks that by 2011 we’ll enough EMR adoption to do a Health Information Exchange pilot and test; that’s when we’ll get the tipping poin, he says, where doctors and others see how cool it is and will want more (like heroin, DeWald says).

Remember: EMR, then HIE, then NHIN (nationwide health information network).

The SD eHealth Collaborative was officially established by Governor Rounds this year! The executive order formalized work that had been going on since 2006, including the 2006 SD Electronic Health Record Assessment and the 2007 Zaniya Project.

The economic model matters! We need to create a system that can sustain itself after we spend the stimulus dollars.

DeWald says number one barrier to adoption is cost (not privacy/security concerns!). Adoption isn’t a new problem; as one prof points out, we’ve got all sorts of research on IT adoption (and resistance thereto) in all fields. The big issue now is making health IT happen.

DeWald notes that health care providers look at a lot fo their data as proprietary. Ask them to exchange info, and they start worrying someone will steal their patients. Perhaps I need to remind my doctor that I own my medical data.

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