This post is authored by James Tcheng, MD, FACC, co-chair of the ACC’s Informatics Committee

As we kick off the 7th Annual National Health IT Week, I’m reminded of just how far discussions around health IT have evolved in a relatively short time. Only a few years ago, the conversation was focused on how to choose an electronic health record (EHR) system. Today, we have moved beyond basic implementation to discussing how best to leverage systems to provide meaningful and timely clinical decision support, improve patient communications, reduce errors, and improve delivery of high quality care.

A recent ACC survey of cardiovascular practices found that 74 percent of practices are using, or are in the process of implementing, an EHR system. In addition, most practices are either already participating or plan to participate in the federal EHR Incentive Program. This is great news on a number of fronts. Not only does more structured and interoperable data enable increase quantitative decision making and improve clinical decision support, the availability of data will ultimately enable a learning health care environment that continuously returns information useful to improving health care delivery, quality, and outcomes. (Important note: Oct. 3 is the last day for eligible professionals to begin their 90-day reporting period for the 2012 EHR Incentive Program. To get the maximum incentive payment, Medicare eligible professionals must begin participation by 2012).

That’s not to say we don’t still have challenges. In fact, one of the biggest challenges is how to best optimize the potential of health IT now that so many providers are on board.  Health technology solutions are inherently complex, requiring substantial resources to maintain and optimize. But there are severe constraints on available resources, and funding is not distributed equally. Changes in the IT portfolios will need to occur without compromising care during transition periods.  Also given the fast-moving nature of health IT, maintaining the security and privacy of information is a challenge. (This will definitely need to be a focus as we move forward with exciting opportunities around mobile technologies).

We also need to move beyond the current emphasis on financial levers to push Meaningful Use compliance.  The real drivers ultimately will be increases in usability, efficiency, and productivity.  Until a true return on investment can be achieved, health IT will remain on the wrong side of the ledger, and thus will be subject to compromise.  A plan for long term assistance with the costs of Health IT should be considered.

When it comes to health IT, my best advice is to never be afraid to tear down what was previously built. Technology evolves rapidly and what was once a good plan/design/technology may not be optimal in the future. We need to be flexible and forward thinking – as do governments, consumers and health care systems. To borrow the National Health IT Week theme, we need to come together with “one voice, one vision [to] transform health and care.”

Be a part of Health IT Week:

• Take part in the “Health IT is…” Twitter Chat on Friday, Sept. 14. at noon ET moderated by @HIMSS and @HealthStandards. Use the hashtag #HITsm and follow ACC's @Cardiology account.
• Visit the ACC’s Health IT Resource Center for information on e-prescribing, the EHR Incentive Program, and choosing and using an EHR.
• Share your thoughts on Health IT on this blog, or on the ACC’s Facebook page.
• For additional information about National Health IT Week, visit healthitweek.org