In a world where many of us as consumers are accustomed to accessing their bank accounts online, checking their location on a GPS or smartphone and booking travel online, it is not surprising that 57% expect their physicians to use electronic health records — EHRs.  This statistic, from John Rother of AARP, seems appropriate in a world of advanced technology.  Actually, one might expect this number to be higher.  What is surprising is that 83% of physicians do not use HIT in their practices to support technology-enabled changes to the supply chain of information.

However, talking about technology and transforming an enterprise through the use of technology are two different things. eHealth Initiative is one organization, like Health 2.0 and many others, that are providing important forums for evolving discussions on this vital topic.  Aneesh Chopra, CTO of the United States, gave the opening keynote at both the Health 2.0 conference in San Francisco this fall and at eHI’s 2010 Annual Conference, occurring now in Washington, DC.  His enthusiasm for the potential of technology was unmuted at both events.  And, of course, in the months between October and January, the initial suite of proposed standards for meaningful use have been promulgated.

Perhaps most striking about the new proposed final rule on “electronic” health records is the myriad of regular mail, overnight mail and courier instructions preceding the actual proposed rule, a rule that seeks to outline the exchange of electronic information!  We dealt with some similar foundational issues in Texas, back in 2000, when as a Governor’s appointee to our eGovernment Task Force, we had to make recommendations to our legislature regarding changes to Texas statute to allow electronic signatures and change the method for verifying certain supporting documentation.  Without these changes, all of our exciting new online activity, from driver licenses to vehicle registration to professional licenses, would be for naught, because once the new online form was complete, the user would still be required to print the form to provide their physical signature, defeating the point of eGovernment.

This is ultimately the point of transformation.  Simply applying technology to existing processes provides an ability to “substitute” new tools for old ones.  ”Augmentation” and “redefinition” come when you rethink processes based on the changed landscape of technology.  That is the ultimate challenge of Health IT, not to simply change chisel and stone to iPhones, but to revision the whole process.