Health Care Reform: Electronic Medical Records and Health IT

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This may not be the sexiest topic known to man, and most of us will run for the hills at the thought of an article around Electronic Medical Records (EMR) and Healthcare Information Technology (Health IT).

But with the stimulus package putting in close to $19 billion (that is right $19 billion). and David Blumenthal, M.D. whose claim to fame is this area writing a couple of review articles on the topic, now in charge of this effort at the White House.  It is worth to learn a little more about it.

There are several resources I recommend (one of which is: Health IT for dummies – and I fall in this category).

This weekend, The Economist devoted a special report entitled, “Medicine Goes Digital,” and includes articles on:

The New England Journal of Medicine (NEJM) also has a series of articles and commentaries, including a commentary entitled, “No Small Change for the Health Information Economy,” by Kenneth D. Mandl, M.D., M.P.H., and Isaac S. Kohane, M.D., Ph.D.  calling for the government to fund open source architecture that the private sector can capitalize on to create a useful health IT infrastructure.

There is also a paper from the Harvard Institute of Health Policy (David Blumenthal’s institute at Harvard), Use of Electronic Health Records in U.S. Hospitals .  What they found was on the basis of responses from 63.1% of hospitals surveyed, only 1.5% of U.S. hospitals have a comprehensive electronic-records system (i.e., present in all clinical units), and an additional 7.6% have a basic system (i.e., present in at least one clinical unit). 

 

The very low levels of adoption of electronic health records in U.S. hospitals suggest that policymakers face substantial obstacles to the achievement of health care performance goals that depend on health information technology.

 

The Wall Street Journal (Big Challenges await Health-Records Transition) outlines Dr.

Blumenthal’s thoughts on the issue as he starts his new job.

 

They include:

 

  • Low Adoption Rates
  • High Costs
  • Technical Complexities
  • Physician and Patient Concerns about Privacy

The federal stimulus bill promises billions of dollars in incentive payments to doctors and hospitals that buy and use the systems, with penalties starting in 2015 for those who don't make the switch. (I am sure that deadline will be moved, as is in all government deadlines except the tax deadlines).

There is a strong possibility that the monies set aside for the Health IT upgrade in the stimulus package could be squandered if we are not careful to include all the additional translational (retraining, conversion of paper records) efforts involved in the transition to EMR.

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