Health Care Providers Failing To Adopt e-Records, Says RAND 228
Nerval's Lobster writes "Back in 2005, RAND Corporation published an analysis suggesting that hospitals and other health-care facilities could save more than $81 billion a year by adopting electronic health records. While e-records have earned a ton of buzz, the reality hasn't quite worked out: seven years later, RAND's new study suggests that health care providers have largely failed to upgrade their respective IT systems in a way that allows them to take full advantage of e-records. Meanwhile, the health care system in the United States continues to waste hundreds of billions of dollars a year, by some estimates. '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,' Dr. Art Kellerman, senior author of the RAND study, wrote in a Jan. 7 statement. Slow pace of adoption, he added, has further delayed the productivity gains from e-records."
Not so fast (Score:5, Interesting)
Need an example? Altoona Regional Health System [altoonaregional.org]
Re:We can trade fraud, waste, and abuse for ID the (Score:5, Interesting)
My physician's office explicitly tells me why they stick with paper-only records: They don't want to deal with the data security mess. They are a medical office, not an IT shop.
Amazingly after all these years on paper records, I don't get double-billed, I've never had a problem between them and the insurance company, and they manage to handle my billing in a timely manner.
Go figure.
Frankly the software stinks (Score:5, Interesting)
I am involved as a consultant to several practices and frankly the software stinks.
Buggy, incomplete, error prone, and over priced.
If I had a nickel for every time I have been told it will be fixed in the next release I would be a millionaire.
I feel sorry for the medical professionals who have to deal with the garbage software on a day to day basis and the consumers who get sub-par service both medical and billing because of it.
One example is:
If one thing is billed another is automatically added to the bill because they were often used together.
The problem: They are no longer recommended to be used together as a better and cheaper test has replaced one of them.
A year and a half later the problem is still in the software and if someone forgets to manually remove it the insurance rejects payment and the patient gets a bogus bill for several hundred dollars.
Quality of Care (Score:4, Interesting)
If I call the hospital to speak to my relative my call is forwarded to a nurses station. That station then looks up the patient list on paper and if my relative is not found they forward my call to a different station. After 3 or 4 forwards I get my relative. Some hospitals in the USA are still in the 1980s.
This will take a generation to solve (Score:3, Interesting)
My wife is an MD and (relatively speaking) is computer literate. She can touch type and navigate typical desktop machines.
Her clinic converted to EHRs several years ago and she still hasn't reached the level of efficiency she had with paper charts. At this point she's gone back to dictating parts of her chart (via speech recognition) to try to regain some of her lost productivity.
A lot of the problem is that the data is VERY free form. The mundane measurements (height, weight, temp, BP, etc) are easy to insert and digitize, and you can pass it off to another health worker to enter it. The really important information, however, doesn't fit into an established structure.
MDs learn how to collect and document patient status during med school and residency. The details vary from one program to the next. The efficiency of an office visit and its subsequent documentation all depend on how well the EMR flow (and even the number of clicks) fits how the MD does an office visit and/or documents a medical procedure.
The disconnect between habits and automation will continue to affect MDs until we have a generation of experience.
Patient Controlled (Score:4, Interesting)
We distribute to 18 countries, but our primary business is in Australia. We do not sell into the US (and don't want to).
In Australia, the government standard for cloud based EMR is 'Patient Controlled'. They call it PCEHR (Patient Controlled Electronic Health Record). We've nicknamed it 'pecker'. In one sense, it is a good idea, as the patient owns their own data and cannot be held to ransom by their health care provider. Arguably, the authorities could never have made the decision for the data to be owned in any other way.
However, it also means that the electronic patient record contains only the data that the patient wishes to include. Any practitioner would be crazy to accept that record as 'complete' - and for the sake of their PI insurance (and the patient's wellbeing), they basically have to disregard the online electronic record and start from scratch every time.
Furthermore, most health care providers value their business based on the IP in their electronic records (more traditionally known as 'Good Will'). They will not willingly give up that information - at least, not quickly.
Sadly, I can't see an easy solution. It will take time and a bucketload of stakeholder engagement by the government - something that most governments are not very good at.
Come back in 10 years.