An HIT Moment with … C. Peter Waegemann

An HIT Moment with ... is a quick interview with someone we find interesting. C. Peter Waegemann is CEO of the Medical Records Institute.

People often compare HIMSS and the Medical Records Institute, often on the basis of their respective conference (the HIMSS annual conference and TEPR). How would you characterize the difference and do you see HIMSS as a competitor?

HIMSS and Medical Records Institute (MRI) have very different goals and points of view. Both started about 25 years ago. HIMSS developed into a very successful “mainstream” trade show with an attached membership organization. MRI’s conferences have emphasized the education component and helping providers to understand the consequences of EMRs and HIT.

For MRI, the main goal was to promote EMRs and to stimulate and provide leadership in standards development. I was instrumental in the initiation of standards organizations such as ISO TC 215, but when MRI felt that there was a lack of meaningful results, it supported ASTM International’s, relinquishing its leadership to HIMSS, which took over technically. While HIMSS has been a strong supporter of ONC, HITSP, and CCHIT, MRI has pointed out the negative influence these efforts have had on HIT developments. 

In summary, MRI has been the counterpoint to HIMSS in terms of strategy.

Why is Medical Records Institute set up as a for-profit organization rather than a non-profit like HIMSS? Is there much of a difference and are other healthcare membership or conference organizations set up similarly?

HIMSS, having gotten the not-for-profit status early on, has been a huge, profitable organization that is well funded, with reserves in the millions. MRI is the small, independent organization that has always been more interested in making a difference than making money. MRI felt that it could be more effective in its mission unfettered by a Board and the complications of a not-for-profit organization.

What is MRI’s point of view on the state of EMRs and best use of any healthcare IT money that’s made part of an economic stimulus package, particularly in light of the National Research Council’s report about the unmet technology needs for improving patient care?

MRI has repeatedly stated that the progress in the field of EMRs is shameful and argued that this cannot be blamed on such myths as lack of physicians’ interest (see this article). 

Unlike other organizations, MRI is not driven by the prospect of big money for the industry. MRI welcomes the prospect of funds to improve the quality of care with technology solutions, but it is one of the rare voices that warns that the expected savings may not occur quickly, that the infrastructure is not ready, and that (as in the past) wrong avenues appear all too likely to be pursued. 

In its letter to President Obama, MRI  asked for orchestrated efforts to determine the necessary healthcare infrastructure changes in order to achieve electronically enabled healthcare. In other words,  rather than rushing into a big spending spree, a national effort needs to be funded that openly addresses all the hypes, explores various and perhaps unpopular strategies, and develops effective ways to spend this money safely and efficiently.

Why did MRI develop an interest in cell phones in healthcare?

MRI has a long history regarding cell phones and mobile technologies. Almost 10 years ago, MRI joined the Mobile Healthcare Alliance (MoHCA) to coordinate cell phone activities in healthcare and I served as chair of MoHCA. Several years ago, MoHCA’s Executive Director joined MRI as Vice President. It has been natural that we followed that industry and recognized its potential value to healthcare.  

There has been a re-emerging wave of mobile phone applications for healthcare. With over hundred companies, this is big and will be disruptive to providers and other stakeholders. MRI calls it the “mHealth revolution”. For this reason, the Center for Cell Phone Applications in Healthcare (C-PAHC) was formed in 2008. 

Mobile devices and applications will be instrumental in the success of many health IT goals, such as documentation at the point of care, success of personal health records, integration of personal health records into EMR systems, disease management, and many more. Most of all, mobile technologies represent the breakthrough opportunity for EMR interoperability and implementation among many other applications. MRI supports the formation of the new, independent, not-for-profit mHealth Initiative Inc. and will encourage its efforts toward accelerating mHealth and its benefits nationally and internationally.

What predictions do you have for the healthcare IT industry over the next 1-3 years?

MRI sees four major drivers for the next three years. The first is, of course, the new Administration and whatever comes out of its efforts.

The second is the “mHealth revolution”, addressed above. Expect, for example, that in 2012 more than 50 million people will have their PHR on a mobile phone and will send information in advance of any visit to a provider. 

The third driver will be the interoperability standards through ecosystems (Microsoft, Google, mobile phone, etc.) that will enable true continuity of care. Expect most of these developments to come from industry innovation, not from traditional standards bodies.  

The fourth driver will be the Internet/consumer movement.

Overall, there should be more progress than in the last 10 years toward a safer, more efficient and cost-controlled healthcare system.