Press Releases & Articles

August 17, 2009

Achieving Healthcare Reform: The Role of Electronic Health Records

By
Irfan Iqbal
Sequel Systems, Inc.

In a live web cast hosted by the Health and Human Services (HHS) Secretary Kathleen Sebelius on Aug 7th, Dr. David Blumenthal, National Coordinator for Health Information Technology answered critics of the administration’s healthcare reform efforts and underscored the role of health information technology in accomplishing it stating that the adoption of health information technology will serve as a catalyst for achieving the goals of healthcare reform legislation.
“I think they are afraid that physicians somehow will be controlled by the information that’s in the record or by guidelines that are in the electronic record. An electronic record, however, assembles for the physician all of the information that is relevant to be able to make an effective decision. It gives them what they need to be correct and wise at the point that the decision has to be made. The electronic health record, by bringing all this information together in one place at one time and accessible to the physician, can advance patient’s health, make the system more efficient and reduce premiums over time as a result.”
Dr. Blumenthal cited an example from his own experience. While ordering a CAT scan on a patient, the computer alerted him that a similar test had already been performed. In fact, "the test had been ordered by another doctor, and as I looked at the results, I didn't need to order that test. I saved the patient the inconvenience and X-Ray exposure, and saved the health care system the money for that duplicate test." Dr. Blumenthal himself also converted from paper to electronic records admitting that it was not an easy task both in terms of changing the way we are used to doing things as well as from a cost perspective. However, he realized very quickly that with more information readily available to him, it made him a better physician. In addition, he added, the stimulus funds should make the transition easier and if health care is to be improved through the use of EHRs then ultimately “it’s the right thing to do”.
Although health care information management arena has been relatively slow in catching up to technology, physicians and others in the health care industry are starting to see the impact that information technology has had on other industries and they are ready utilize technology as a tool as well. With President Obama’s economic stimulus package offering monetary incentives for adoption and use of EHR through the HITECH Act, which qualifies hospitals and physicians proving “meaningful use” of an EHR for $17 billion worth of incentive payments from Medicare and Medicaid over a five-year period, the transition seems to be more achievable than before.
“It's an investment that will take the long overdue step of computerizing America's medical records to reduce the duplication and waste that costs billions of health care dollars and medical errors that cost thousands of lives each year.” [President Obama’s Remarks at Stimulus Bill Signing Tue Feb 17th 2009]
While the exact definition of “meaningful use” will be determined by the HHS at the end of this year, the legislation outlined three requirements: e-Prescription, electronic exchange of health information and reporting of clinical quality measures.
“The ultimate vision is one in which all patients are fully engaged in their healthcare, providers have real-time access to all medical information and tools to help ensure the quality and safety of the care provided while also affording improved access and elimination of health care disparities. This ‘north star’ must guide our key policy objectives, the advanced care processes needed to achieve them, and lastly, the specific use of information technology that will enable the desired outcomes, and our ability to monitor them.”
[Preamble | “Meaningful Use: A Definition” | Recommendations from the Meaningful Use Workgroup to the Health IT Policy Committee | June 16, 2009]
Health IT will play a tremendous role in the realization of this vision, which is highlighted by the Meaningful Use Workgroup’s early call for adoption of electronic health records (EHRs) and computerized physician order entry (CPOE), including time and cost-saving features such as electronic transmission of permissible prescriptions and incorporation of lab-test results into EHRs. According to an Institute of Medicine report, each year an estimated 100,000 people die from medical errors in hospitals. EHRs will improve patient safety reporting and data analysis and prevent such errors by providing built-in safety management protocols and risk-assessment tools including early warnings and alerts. In addition, they will also prevent duplicate tests by reminding physicians about preventive services. As mentioned by Dr. Blumenthal in the web cast:
“Health IT can empower all kinds of improvement in preventive care, in acute care and chronic care. [The doctors] won’t miss when the mammogram is due, or that influenza immunization. We know that prevention is a very important way of avoiding health care costs. Finally, by making sure that the administration of bills or of claims is more efficient, it can greatly reduce the waste we all know is part of the administration of our very very complicated health insurance systems.”
Healthcare reform is needed, almost everyone will agree, simply because as a nation we aspire for quality care. In fact, as President Obama said “healthcare reform is no longer just a moral imperative; it’s a fiscal imperative. If we want to create jobs and rebuild our economy and get our federal budget under control, then we have to address the crushing costs of healthcare this year in this administration.” However, how it will be achieved is always debatable. At least, one thing is certain that it will require a meticulous and committed approach and cooperation between all the players in the healthcare arena. To that end, the role of health information technology through the use of electronic health records as a major player is both critical and inevitable at the same time. In terms of long-term savings as a result of health information technology, analysts at RAND Corporation estimate the figure to be about $77 billion a year. Hence, the challenge lies not in its necessity – whether it should be done. Rather, it lies in the approach – how it should be done. Many have and will continue to raise myriad concerns, whether from a technology, privacy or security point of view. However, as stated by Dr. Blumenthal, “it is a journey we must take if we are to improve care through the use of EHRs.” As we progress towards the ultimate vision, utilizing technology to provide secure, timely and logically organized access to health information will become more realistic, imperative and ultimately meaningful. And yes, it is the right thing to do.