Benjamin Nagy

Often when a patient walks into a provider's office, he or she might not have any idea about the total cost of the visit—except what the copay might be.

There's no doubt that the United States is in a transition when it comes to the use of health information technology (HIT). President George W. Bush's executive order for increased use of HIT and health information exchange (HIE) to improve quality and cut costs in August served as a reminder.

Initially used to transcend problems of distance and location, telemedicine employs cameras, microphones and other medical monitoring devices, which are connected via a telecommunications network in the evaluation, diagnosis and treatment of patients from remote locations. The observational devices can be anywhere, which allows for the technology to be used in diverse settings or to treat prisoners, soldiers and the homeless.

A more consumer-centric approach to healthcare has caused health plans to forgo the communications strategies of old. Consumer-directed benefit products such as health-savings accounts (HSAs) have caused consumers to shoulder more responsibility in making healthcare choices to make their dollars go farther and to weigh carefully the cost, quality and necessity of the care they purchase.

The healthcare industry, both nationally and globally, has just scratched the surface of possible uses for telemedicine with potential efficiency enhancements on the horizon as well as a future where homes would have "health security systems," according to some leaders in telemedicine.

With its first phase of certification rolling, the Certification Commission for Healthcare Information Technology (CCHIT) will concentrate on maintaining its momentum while moving to the realm of inpatient electronic health records (EHRs) in its second certification phase, followed by the evolving EHR network infrastructure in phase three.

Building and applying the technology of the electronic health record (EHR) is a decidedly non-magical process far more complex and less instantaneous than just making the paper disappear into a wastebasket. Quality concerns about EHR systems must be addressed, which is why the Certification Commission for Healthcare Information Technology (CCHIT) exists. A voluntary, private-sector initiative based in Chicago, CCHIT was established in 2004 to foster the adoption of robust, interoperable health IT in the United States through product certification. In 2005, CCHIT received a three-year contract from the Department of Health and Human Services, making it the key entity to develop and evaluate criteria for the testing and certification of EHR systems in the United States.

National reports —A trio of business agreements announced this spring are indicators that the healthcare industry may be fully embracing the concept of disease management to help lower costs, improve care and focus on a "whole-person" approach to providing patient care.