Electronic Medical Records A Disappointment In The USA

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Electronic Medical Records A Disappointment In The USA

Main Category: IT / Internet / E-mail
Also Included In: Public Health
Article Date: 13 Jan 2013

Electronic medical records arrived with a fanfare in 2005, promising huge cost savings, better accuracy and efficiency - most health care professionals and authorities have been disappointed, stating that systems overall are not user-friendly and badly integrated, says a new report issued by the Rand Corporation, a non-profit organization.

The authors of the new report state that the potential of health information technology to reduce spending as well as improve patient care will never materialize if health care providers do not reengineer their processes to focus on the benefits that could be achieved.

Dr. Art Kellermann, senior author, and Paul O'Neill Alcoa, Chair in Policy Analyziz at Rand, said jointly:

"The failure of health information technology to quickly deliver on its promise is not caused by its lack of potential, but rather because of the shortcomings in the design of the IT systems that are currently in place."

A team of IT experts from Rand Corporation in 2005 published an analysis that predicted "widespread adoption of health information technology" that would eventually save America over $81 billion in better delivery and efficiency of health care annually.

Today, seven years on, the evidence about the efficiency and safety of information technology in the USA is far from compelling. Annual healthcare spending has rocketed upwards by a whopping $800 billion every single year!

Co-author Spencer S. Jones, and Kellerman concluded that a much more compelling vision is required to attract funding into health information technology. They offer the following suggestions:

For health information to work properly, it needs to be stored in a single IT system and be easily retrievable by others, including physicians and hospitals, who belong to other health systems. The authors stress that this is vital, especially in emergency situations.

Patients should by right have easy and ready access to their electronic health information, in the same way a bank customer has access to his/her account data. Patients must be able to see their own records, share them with doctors and other health care professionals and providers of their choice.

Health information technology systems must be geared towards making a doctor's job easier and more efficient. If all it does is add to his/her workload, it is a complete waste of money and time. Systems should be user-friendly, which the authors describe as "intuitive". Busy health care providers should be able to use them easily without having to attend extensive training programs.

Physicians and other health care providers should be able to use systems across different health care settings with ease, in the same way a consumer drives various models and makes of cars.

Several media reports this week mention that a significant number of healthcare providers would rather bypass the incentive checks and even pay up the eventual penalty fees than have to deal with the bother of implementing electronic health record systems. If this is occurring in a big scale across the USA, something needs to be done urgently to make the implementation and everyday usage of these systems more practicable.

Learn from other countries, say some experts

Some say that the USA should liaise with other countries which have successfully created and implemented electronic health care records systems in a big way nationally, such as the United Kingdom.

Professor David Blumenthal of Harvard University, and Dr. Jenniffer Dixon, of the Nuffield Trust, UK, stress that in technology, organization and financing, the two nations could learn a a lot from each other. They said "Comparing health reforms in the USA and England seems to be an unlikely project: many people in both countries view the other as having a pariah health system that is not to be copied in any circumstance. But both countries are under pressure to get more value out of health care spending and reduce growth in expenditure to sustainable levels, and are consequently experimenting with new ways to encourage clinicians, patients, and institutions to help achieve this."

Several studies have looked at the benefits of electronic health records, with mixed results:

Researchers from Weill Cornell Medical College reported in the Journal of General Internal Medicine that doctors who go digital provide considerably better healthcare, compared to those who do not.

A team from the RAND Corporation wrote in the American Journal of Managed Care that electronic health records usage has only had a limited effect on improving medical care quality in hospitals in the USA.

Northwestern Medicine researchers reported that patients who are at high risk for CVD (cardiovascular disease) are more likely to receive a prescription medication for cholesterol-lowering drugs when their doctors use electronic health records. They added that those patients are also more likely to achieve lower long-term cholesterol levels. They reported their findings in the Journal of General Internal Medicine.

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