By: Suma Kallurkar, CIS Senior Manager
sumakallurkar@cis-partners.com
Among the many provisions in the approximately $787 billion economic stimulus bill that the US House and Senate came to agreement on recently, one very interesting one is a $19 billion provision to implement a national Health Information Technology (HIT) system for use by doctors and hospitals. In other words, we are talking about the implementation of an electronic medical record system – an issue that the health care industry has long been considering and debating. With the current Obama administration pushing for this modernization of health care technology, we may finally see an electronic medical record system be adopted in the near future.
Many of us have experienced receiving a not-so-legible hand-written prescription from a doctor that could be mis-interpreted by a pharmacist. I recently experienced a social security number notated incorrectly on official medical papers, and in turn manually corrected. It is obvious that one of the most significant benefits of electronic medical records is the reduction of such errors. When it comes to notating drug and treatment information, such errors can be fatal. An electronic medical record system would achieve significant efficiencies in health care by significantly reducing administrative errors and their associated negative health outcomes.
Proponents of electronic medical records believe that improvements in health care can also be achieved by the sharing of medical information that such technology would facilitate. An electronic medical record system would allow for faster and easier communication of a patient’s medical history, current prescription drugs, treatment regimen, etc. between doctors and hospitals. Such easier and faster sharing of information can allow health care providers to make more informed and faster decisions in treating a patient.
On the reverse side, opponents of an electronic medical record system (as being advocated in the stimulus bill) worry that easier access to medical information will infringe on a patient’s right to privacy. Many fear that businesses will be able to access patient health information and use it for sales and marketing purposes. Strong concerns also exist about the government having access to patients’ records and interfering in medical decisions made between doctors and patients. However, the bill agreed upon between the Senate and House calls for stronger privacy law to protect personal medical data from wrongful use.
On February 17, 2009 President Obama signed the $787 billion economic stimulus bill into law. How the money will be spent, and how quickly it will affect Americans, remains to be seen; however, the implementation of an electronic medical record system was indeed a significant component of the final stimulus bill. If we ensure the protection of patients’ health information against misuses, then an electronic medical record system adopted on a national basis should indeed result in significant improvements in quality of health care and billions of dollars in cost savings. Achieving such efficiencies in health care could be a key component in getting the economy back on the right track.
References:
http://www.speaker.gov/newsroom/legislation?id=0273#health
http://www.bloomberg.com/apps/news?pid=20601087&sid=aOQrsih0y1BU&refer=home
http://www.foxnews.com/politics/first100days/2009/02/11/critics-says-stimulus-gives-government-say-health-care/
http://blog.hittransition.com/
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Electronic Medical Records (EMRs) are essentially digital treatment platforms that contain significant patient variables, such as their own medical history. This and relevant knowledge and data relevant to the individual patient assure to a higher degree that the treatment they receive from their health care provider when it is needed is reasonable and necessary. EMRs have the potential to prevent medical errors that occur, unfortunately. Such errors are believed to cause nearly 100 thousand deaths every year.
Present medical records on documents are digitized and integrated into the EMR easily. And EMRs are desirable in the medical community for a number of reasons that fill unmet needs to restore the health of others. These health care provider assets provide evidence-based clinical information contained in this knowledge system.
In addition, EMRs provide additional patient safety, regulatory and reporting needs. These needs, as well as confirming reimbursement requirements, provide a strong ROI for those medical facilities that have quality EMRs at their location.
The first large demonstration of the effectiveness of EMRs was with the VA Hospital’s Vista System. The code was written by doctors for doctors, and has about 18000 pages within Vista. Author Phillip Longman wrote a book about this system and the quality it allowed for superior health care, which was entitled, “Best Care Anywhere.” The Vista is the largest EMR in the United States
In addition to EMRs storing patients’ medical history and present treatment regimens, EMRs make others aware when ordering ancillary testing for patients. The awareness is to make sure the testing ordered is not repeated, or does not already exist. In addition, and of particular importance to the health care provider, the need for transcription of patient notes is eliminated.
With some debate, there seems to be a good possibility for the development of increased profits for both health care providers and medical institutions. This is due to EMRs offering the most appropriate and accurate codes. These are diagnostic and procedural codes allowable for a particular patient as they are determined to be needed for this patient. These codes are used to seek reimbursement from health care payers, and are required for reimbursement from third party payers for certain patients.
The continuity of patient care improves the care of patients and reduces the need of additional patient staff that was needed before EMRs arrived at the medical facility. Historically, there is often a lack of needed staff at medical institutions due to the shortages of professions that exist in the health care field, such as nurses.
The EMR provides flexibility of architecture to meet individual workflow requirements at each location. Preventative medicine and compliance with treatment regimens are more assured with EMR utilization as well.
Again, evidence-based medicine as well as a higher degree of patient-centered healthcare is now possible and improved by EMRs. The many benefits perceived by others that are based on fact has resulted in the utilization of EMRs by various managed care companies and pharmacy benefit management companies.
However, health care providers who are in solo practice are understandably reluctant to acquire an EMRs because of cost. The cost of an EMR may approach 40 thousand dollars, as well as several thousands of dollars paid annually to maintain the EMR. A complete EMR package would include hardware, software, installation, maintenance, and training.
One of the primary functions of EMRs often includes electronic prescribing, which is more reliable in reducing prescription errors, which are believed to cause over 5 thousand deaths a year. Electronic prescribing also lets the health care provider know if there is a generic version of the drug available, and if the patient’s pharmacy insurance benefit covers the drug chosen by the health care provider.
Additional functions of EMRs would include the ordering diagnostic tests, and retaining the results of these tests. Also, the documentation from the health care provider about the health and well-being of their patient after a visit with such a provider is placed directly upon direction from the provider into the EMR. This thankfully improves patient data availability for other health care professionals may have a need to retrieve regarding these patients.
Aside from having great ability to store information and data, as well as the EMR having user-friendly navigation, the EMR should have the following core functionalities: Health information and data about disease states and patients that have been treated, the, ability to manage results, the features to allow order entry, the ability to provide decision support, and the EMR should have good communication with other devices.
As far as the plan of implementing EMRs within a medical facility, this would involve the EMR’s hardware, software, EMR installation, maintenance of the EMRs as determined, and training of the medical staff.
Additional patient benefits because of the ability and function of EMRs is the reduction in mortality, according to some studies. Mortality has been concluded to be reduced by around 40 percent. Equally impressive is that the EMR makes patient care much more efficient, including where efficiency may be needed the most. That would be those many patients who have at least one chronic disease. Chronic diseases consume around 80 percent of health care spending. The EMR facilitates a medical home for those patients who are chronically ill..
Surveys have shown that most people surveyed favor EMRs more than they do a health care provider visit. The EMRs allow and encourage written dialogue between the health care provider and their patients. When this is done, visits between these patients and their providers are significantly decreased.
Presently, those who have access to EMRs range in ages of those in their late teens, to those in their early 90s. Utilization of EMRs by others is not limited because these records are very user-friendly for most people. And utilizing EMRs may also be used to enhance one’s medical knowledge regarding a particular topic or disease state. With those who are with medical problems, this knowledge often will improve their health and their medical issues because the patient is now an advocate in their own treatment of their medical problem.
EMRs are certainly not flawless, and there are those that oppose the integration of this digital advance into the U.S. Health Care System. There are privacy concerns, as well as more valid concerns about EMRs becoming dysfunctional without notice. Presently, those who make EMRs in this 20 billion dollar a year industry are not regulated, and no uniform standards regarding their durability have been established. So likely, some EBMs are overall better than others,
Dan Abshear
This is a very interesting post onIT and health care joining together for maximum efficiency t. I still believe that our private info should not be transferred digitally, only stored digitally and not connected to the web in anyway.
Check this out , pretty disturbing already
http://www.nextgov.com/nextgov/ng_20090227_9147.php
But as with anything in life there are pros and cons, the trick is finding the best solutions
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