The wave has finally broken: now what

From Clinfowiki
Revision as of 19:54, 28 October 2015 by Katkuri kristina (Talk | contribs)

(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)
Jump to: navigation, search

This is a review of the 2013 article, “The wave has finally broken: now what?” by Donald W. Simborg et al.


In 1991 Institute of Medicine produced a report, the Computer-Based Patient Record, which suggested that computer based records would become the standard record for healthcare in 10 years. Causing debate and discussion, it was determined that 10 years was unrealistic and it would be about 20 years before it would become the standard. Fast forward to 2005, an article was published, “Will the wave finally break?” an article on adoption of Electronic Health Records (EHRs). By 2013 nearly 70% of physician offices and 74% of health systems had adopted EHRs. With adoption rates as such, “The Wave has finally Broken: now what?” looks at the after effect of EHR adoption, both positive and negative. [1]

Positive effects of EHR adoption

With the adoption of the EHR came the establishment of the Office of the National Coordinator (ONC) in 2004 and in 2009 the Health Information Technology for Economic and Clinical Health (HITECH) Act. With the development of the ONC, $19Billion dollars was allocated to ONC and the Centers for Medicare and Medicaid Services (CMS) to promote the meaningful use (MU) of Health Information Technology (Health IT). Subsequent to ONC and the HITECH ACT, many positive developments have occurred regarding the adoption of EHR’s such as a higher adoption rate of EHR’s, quality improvement, patient portals, and workforce development.

Negative effects of EHR adoption

With all things good, there is always a downfall, as there has been with the adoption of EHR’s. Several issues were brought to light by the HITECH Act regarding the adoption of EHR’s, such as lack of a trained workforce and privacy and security issues. Along with the issues brought to light by the HITECH Act, several other issues have been brought to light, such as usability issues, distrust, a lack of interoperability, market barriers, and the potential for fraud and abuse.

Great article on the negatives from a physician perspective by Charles Krauthammer


It is interesting to look back into the past and see how far we have come since then. What is scary is that most of the technology and issues we are experiencing were predicted in the past. It is concerning to me that although our issues were predicted, not much has been done to rectify them. While Information Technology (IT) is still rather developing in healthcare, it has rapidly developed elsewhere in society. I feel we should learn from the creation of other technology, as there is much to be learned in my opinion. I am highly concerned with privacy and security, especially after reading that it has been a concern for such a long time. If we do not take control of our Health IT, fraud and abuse will continue to run rampant, as it has been. If privacy and security is not a concerning issue to you, perhaps when your privacy and security are in jeopardy, it will be, as it is right now with limited privacy and security measures implemented, all of our privacy and security is in jeopardy when it comes to Health IT.


  1. Donald W. Simborg et al. 2013. The wave has finally broken: now what?. http://