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Electronic Medical Records Still Need Work, Report Says

Electronic Medical Records

RICARDO ALONSO-ZALDIVAR   01/26/12 11:02 PM ET  AP

WASHINGTON — America may be a technology-driven nation, but the health care system's conversion from paper to computerized records needs lots of work to get the bugs out, according to experts who spent months studying the issue.

Hospitals and doctors' offices increasingly are going digital, the Bipartisan Policy Center says in a report being released Friday. But there's been little progress getting the computer systems to talk to one another, exchanging data the way financial companies do.

"The level of health information exchange in the U.S. is extremely low," the report says.

At the consumer level, few people maintain a personal health record on their laptop or electronic tablet, partly due to concerns about privacy, security and accuracy that the government hasn't resolved.

"How will sensitive health data be kept confidential and secure in digital data-sharing environments?" the report asks. "Many consumers ... are waiting for a reassuring answer to this question."

The report offers a window on progress toward a goal set by President Barack Obama, and President George W. Bush before him, that everyone in the United States should have an electronic medical record by 2014.

While making no predictions, the report offers a collection of details indicating that the goal is a long shot at best.

"Will 100 percent of our nation have electronic health records by 2014?" asked Janet Marchibroda, who directs the center's health technology initiative. "I would say getting to that last mile is difficult." She expects the majority of hospitals and doctors to meet the goal, but it's another matter when it comes to consumers.

In politically polarized Washington, the center tries to tackle national problems from a pragmatic perspective. The report, more than six months in the making, was produced by a panel representing hospitals, doctors, insurers, consumers and technology companies. The review was led by two former senators with ties to the health care industry, Democrat Tom Daschle of South Dakota and Republican Bill Frist of Tennessee.

Electronic medical records are seen as a crucial component in creating a system that's more efficient and less prone to error. The government has committed up to $30 billion to encourage this shift, mostly through incentive payments to hospitals and doctors that were authorized in 2009 under Obama's economic stimulus law. Payments started flowing last year.

The report found that 5 percent of eligible doctors received payments last year, while about 33 percent had registered with the government that they intend to qualify.

Overall, about one-third of doctors' offices had some form of electronic records last year, compared with one-fourth in 2010.

Among hospitals, 32 percent received the incentive payments last year, the report said, while 61 percent notified the government they intend to qualify.

Those are signs of momentum, but the report found little progress in devising ways for the different computer systems to communicate with each other.

Part of the problem is that there isn't much financial incentive for competing health care providers to share information.

If an emergency room orders a test on a patient that a family doctor had run a week ago, the hospital gets paid for it. If the emergency room doctor relies on the test results from the family doctor, that's less revenue for the hospital.

"Health information exchange will not occur at optimal levels ... without a viable, sustainable business model," the report said.

Only from 7 percent to 11 percent of individuals have a personal electronic medical record. Some early adopters still run into problems with basic tasks such as downloading test results, renewing prescriptions online or scheduling appointments.

The report also says the government must address gaps in privacy protections. For example, a federal health privacy law that applies to hospitals, doctors, insurers and data transmission companies doesn't apply to companies that market electronic medical records directly to the public.

"This uneven coverage of federal health privacy law can be confusing for consumers and contributes to reluctance," the report said.

____

Online:

Bipartisan Policy Center: www.bipartisanpolicy.org

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WASHINGTON — America may be a technology-driven nation, but the health care system's conversion from paper to computerized records needs lots of work to get the bugs out, according to experts wh...
WASHINGTON — America may be a technology-driven nation, but the health care system's conversion from paper to computerized records needs lots of work to get the bugs out, according to experts wh...
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09:32 PM on 02/01/2012
Worth looking at:
http://www.lrha.org/pdf/WorldVistA%20EHR.pdf
09:28 PM on 02/01/2012
Oh - and after Katrina- only the VA patients had their records.
It does make it a little harder to get narcotics from multiple sources etc.
09:26 PM on 02/01/2012
I would not go to a doctor not attempting the EHR- this would mean they are slow to change witht he times and you don't need that in a health care provider.

The VA has used a EHR for 15 years- other countries use it. It is free public domain as the tax payers paid for it. While not perfect it is very good and they are working on improving it. BEst os all FREE! Most of the EHR doctors pay for use parts of it. They prob make Billing better than this one - bust still. HEre is the free demo
http://www.ehealth.va.gov/EHEALTH/CPRS_Demo.asp
04:53 PM on 01/31/2012
While health information exchange (HIE) is the inevitable goal of (http://www.healthfusion.com/ehr-platform.asp)electronic medical records (EMRs), implementation must happen first. While HIPAA and CMS have helped with current EMR regulations, once full EMR adoption occurs by 2014, HIE will then become the focus for physicians and vendors alike. The United States does not want to run into the same problems faced by EMRs in England. And as emily comments, data exchange is a bad idea without proper security measures and laws in place across all EMRs, not just the prominent ones. Also, more EMRs must incorporate (http://www.healthfusion.com/patient-portal.asp) Personal Health Records (PHRs) and Patient Portals that allow patients access to their medical records, lab results, and even connect with their physician away from the office. Also as physicians continue to adopt mobile tablets, like the (http://www.healthfusion.com/ehr-ipad.asp) iPad, EMRs will become far more prevalent.
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jfbuf
people are corporations too
04:14 PM on 01/31/2012
I can tell you that the doctors my wife and I go to won't be having electronic medical records anytime soon, their barely in the computer age
03:36 AM on 01/31/2012
You don't want this until the US has serious data privacy and integrity laws.

I live in country that already has these. Nurses and even doctors sometimes routinely get in trouble for snooping in people's records. You can just imagine the potential for abuse in a place like the US. No doubt corporations are salivating at the mouth for the data.
JWoode
yes.. my micro bio is empty
11:34 PM on 01/30/2012
It's far too soon for medical records online.. that stuff would be safer on Facebook.
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Wayne Caswell
Consumer Advocate & Founder of Modern Health Talk
11:20 AM on 01/30/2012
We're still early in the transition to electronic records, so early adopters naturally find (and correct) bugs, and the 7-11 percent adoption at this point is not bad. Getting to 100 percent, however, is daunting. Privacy remains an issue but will be less so as laws prevent insurance and employment discrimination based on medical conditions or personal DNA sequencing, which promises to help predict predisposition to conditions far enough ahead of time to actually guide prevention plans.
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Zaida Adams
06:32 AM on 01/30/2012
Perhaps I might speak out of ignorance, but I would like to see medical records go digital that all doctors may access my records. The time spent in diagnosis, or repetitive diagnosis, could cost a life. Is it really that crucial that medical records remain that restricted? What's the reason? Recently my mother broke her foot. Would have been simpler if the organisations had a central database where they could have accessed her x-rays and data. Would be fantastic for travellers, also, if the doctor could access that person's medical records.
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jfbuf
people are corporations too
04:16 PM on 01/31/2012
I agree, if we lived in a perfect world but I don't see that happening anytime soon.
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Zaida Adams
08:58 PM on 01/31/2012
Yes, neither do I.
09:11 PM on 01/29/2012
EMR's are extraordinarily expensive to purchase and then implement. Without a national system, they can only help individual institutions, which isn't necessarily a bad thing. Their value seems to diminish in smaller practices. And as long as we want to keep our health care private, there's NO WAY for all these different systems to communicate with one another. It seems like EMR would be great for health care, b/c it's just data. But it's far far far more complicated and difficult than that, just like people, their lives and health are tremendously complicated and difficult.
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Wayne Caswell
Consumer Advocate & Founder of Modern Health Talk
11:04 AM on 01/30/2012
Expensive? A lot less so than paper-based systems, and the space to store it all, and the duplicate efforts when paper records aren't available.
11:52 AM on 01/30/2012
Again, depends on practice size. For small practices, yes: very very expensive. And for large institutions, it costs millions to purchase and transition to. All I'm saying is EMR is still pretty Pie in the Sky. It's an investment and the payoff can take years. Not all practices have that kind of capital. Yes. Expensive.
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jfbuf
people are corporations too
08:30 PM on 01/29/2012
why don't we just do it on facebook
RACVC
Forever Young - B. Dylan
02:33 PM on 01/29/2012
My concern with EMR's is the greater loss of confidentiality. It's one thing for me to store patient records in my office and maintaining the strict confidentiality my patients can trust.

Once records are released on line anyone or any organization has a much stronger ability to gather that private information, albeit illegally.
I fear the Wikileaks of the EMR is imminently in our future.
02:57 PM on 01/27/2012
Well, my office converted to electronic medical records. We are not owned by a hospital or corporation, so we paid the 250,000 dollars out of our pockets. The decrease in patients seen for MONTHS is staggering. With that loss of productivity, my take home pay went to ZERO for months. When I finally learned enough to increase the number of patients seen to give me a teacher's salary--I was working until 9pm EVERY night. You can see where this is going. I quit. Many doctors in this smallish town have quite for the same reason--EMR looses productivity with a concommittent loss of revenue. I'm now working in a Free Clinic--if I'm not going to make money I might as well be seeing patients who can't afford medical care. The UK found that EMRs did NOT help their system after YEARS of having it. Good luck America--we're going to need it.
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Chas53
09:30 PM on 01/29/2012
Ouch
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Wayne Caswell
Consumer Advocate & Founder of Modern Health Talk
11:09 AM on 01/30/2012
At that rate, your EMR vendor won't last. 'Sorry to hear about your difficulties; it gives EMR a bad rep. As a retired IBM technologist and systems engineer, I've seen good systems and bad. Yours, it seems, was quite bad, but at some point I hope you'll open up to EMR again.
09:16 AM on 01/31/2012
I am an EMR trainer and worked with several doctor offices and implemented systems from atleast 6 different vendors. I have seen doctors (mostly older doccs) struggle to use basic systems. They cant type a word, hate to click..May be we need a mind reading technology? I have also seen young doctors use the same system with less then 20 minutes training.
EMR is the like the bigggest adult education program in the country. Its amazing to see how many doctors have a fear of computers