Hopefully, the day will come when everyone will have an electronic health record (EHR) that is easily accessible by the patient and the patient’s care givers, protects patient privacy, and—the real gold standard—is accessible by different providers, such as hospitals.
The Obama administration certainly thinks EHRs with that “interoperable” capability are essential; it’s dedicated $30 billion of taxpayer money into creating just such a system. The question is whether all that money and top-down government control has promoted or impeded a successful EHR model.
The smart money is on the latter.
The goal behind EHRs was to get health care providers to digitize medical records, which was supposed to save money and improve the quality of health care. However, a number of studies (see here) have been done and virtually all of them claim that the effort has achieved neither goal.
A recent New England Journal of Medicine study found that just one in six doctors had adopted EHRs.
One problem has been government regulations. As Forbes health IT contributor Zina Moukheiber writes, “Government rules which prescribe a one-size fits all approach for everyone, from recording height (even for, say, an orthopedic surgeon), to implementing five clinical decision support ‘interventions,’ have turned out in some cases to be cumbersome.”
Another problem is the cost. Implementing the EHRs can be very expensive. Even though doctors can get up to $44,000 if they are able to implement EHRs in a “meaningful way,” that’s not enough to cover most of the costs. And the transition from their written records to digital ones can be very time consuming.
On the other hand, if doctors and other providers don’t have an EHR system up and running by 2015 they face a penalty—Or is it a tax? Would someone call Chief Justice Roberts for clarification?
Frankly, many providers see what the government is pushing as a costly and time-consuming effort that benefits neither their patients nor their practices.
Now contrast the response to EHRs with the widespread adoption of mobile devices. Doctors and hospitals are embracing that technology in droves. Provider demand is pulling that market along, rather than government bureaucrats pushing it.
I suspect the day will come when electronic health records will be an essential part of the health care system. But the government’s effort to make it happen has probably postponed it for years.
March 14, 2013