After decades of fits and starts, electronic health records adoption is becoming reality, thanks in no small part to the federal incentive program for "meaningful use" of EHRs. But the health IT industry still has plenty of room to evolve.

"EHRs are simply the on ramp. Once you tie the data together, all sorts of things can happen," Stanley Crane, chief innovation officer at EHR vendor Allscripts Healthcare Solutions, said Wednesday at a health IT leadership conference in Chicago to launch IBM's eighth Healthcare Innovation Lab. "It's really not so much about the technology, it's about the information," Crane said during a panel discussion on the changing face of healthcare technology.

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Crane asked the audience a question he often likes to pose: "When's the last time you had a tetanus shot?" People laughed because few actually knew. At the doctor's office, this would likely mean receiving another tetanus shot, even if the patient was current on vaccinations. "You shouldn't get the healthcare you don’t need," Crane said.

Jaime Parent, associate CIO at Rush University Medical Center, Chicago, recounted how a physician told him that the best kind of patient is a new patient because the doctor can run all kinds of diagnostic tests and charge appropriately, whether they're needed nor not. The panelists, also including Abel Kho, MD, co-executive director of the Chicago Health Information Technology Regional Extension Center (CHITREC), and Healthcare Information and Management Systems Society (HIMSS) President and CEO H. Stephen Lieber, mostly agreed that IT and shifts in payment models will remedy this situation.

"'Never events' are the obvious ones that nobody was going to complain about" if they don't get reimbursed, Lieber said, but providers need to get used to not being paid for other ineffective care. "'Comparative effectiveness' didn't sound good to politicians or the public, but we'll see more 'do not pay' rules based on work coming out of AHRQ," Lieber said, referring to the federal Agency for Healthcare Research and Quality.

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"I don’t want to pay you for lab tests. I want to pay you to review all the tests that were done before," added Crane. "In lab results, it's not the numbers that matter. It's the trends that matter." IT can enable that, he said, but payment incentives do need to shift first.