What’s Really Going on with Electronic Medical Records?

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January 14, 2013; Source: Washington Post

NPQ would like to hear from readers about this important issue: what should be done now that the promises made regarding the benefits of electronic medical records are called into serious question?

In a recent editorial, the Washington Post notes that a 2005 Rand Corp. analysis projected that the United States could save $81 billion in health care costs each year and vastly improve patient care by digitizing patient records and other data. On this basis, the federal government has poured many billions into incentivizing the switch and community health centers have worked long and hard to ensure that they were poised with electronic medical records (EMRs) to take on a larger role in the country’s new healthcare scheme. But now, seven years later, another article by Rand researchers admits that the effort has not yet produced any cost savings but, to the contrary, may even be costing the taxpayer more.

A New York Times article from September of 2012 titled “Medicare Bills Rise as Records Turn Electronic” noted, “The move to electronic health records may be contributing to billions of dollars in higher costs for Medicare, private insurers and patients by making it easier for hospitals and physicians to bill more for their services, whether or not they provide additional care.” This is often done through the “upcoding” of services. In fact, according to the new Rand report, in the years since its prior study, “annual health care spending has grown by $800 billion annually.”

On top of that, there are mixed findings as to whether or not EMRs have improved quality of care. Some records do not integrate well between institutions and many are not user-friendly. The slowness of adoption, say the Rand researchers, is a big part of the problem here, but how much credibility do they have? Now the big brains at Rand are suggesting that the “failure of health information technology to 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.”

Now you tell us. The recent study’s co-authors suggest that to realize the potential of electronic medical records:

  1. They should be be stored in a single system that can be easily used by a range of providers;
  2. Patients should be able to access their own data so they can share it with their own providers; and
  3. Health information technology systems should be designed to make a doctor’s job easier and more efficient.

But as this article in Data Center Journal states, “the scientific veneer for justifying financial incentives by the federal government has largely evaporated. Some incentives may remain, but the heyday has passed.” NPQ would love to hear from providers about this most recent wrinkle in the transformation of healthcare in the U.S. –Ruth McCambridge

  • Mitch Bruski

    As both a provider of services and developer of EMR software, I am in a unique position to comment on this. The article presents the issues very clearly: The plan was to save money, streamline billing and improve care and this has not happened for the three reasons the authors have suggested: All involve the theory versus the practice of information technology

    1) Single system storage with access to many- This is easier said than done. There are many EMR systems and they are not designed to “talk to each other.” They are designed to integrate services with billing. States have begun to develop information exchanges to do this that will be complex and add cost to the equation.
    2) Patient access- Also a noble pursuit, but a complex undertaking. With the additional requirement of HIPAA security standards to assure confidentiality, this capacity is reachable but also expensive as the data must be sent in a complex encrypted format.
    3) System design to make provider’s job easier- Again a great idea and for most software companies, a difficult task because successful design requires knowledge of both business processes and IT programming, a rare combination in most people.

    It may have been more realistic to say that these systems will be able to make more complex requirements manageable rather than to save money. There are ways to save money like a single payer system (e.g. Medicare) instead of a network of different for profit insurance companies, but that decision may be even further down the line.

  • Ruth McCambridge

    Thank you Mitch. This is very useful. I have to admit that I have been one of those waiting to watch for the unanticipated consequences of this initiative which looked to me to potentially achieve astounding proportions. This dissapointing midway outcome, therefore, seems tame. I would still love to hear from community health centers – even anonymously.

  • Snappa55

    EMR SAFER? I think not. Click, click, click, click! OOPs what about all the wrong clicks, the wrong medications entered and given, the little scanners that usually DON’T scan and how about the patients that don’t get ANYTHING because the caregivers are too busy clicking the appropriate boxes proving you got the appropriate care which in reality YOU didn’t! because come to find out the staff was really playing angry birds, looking at facebook,, reading their e-mails, e-mailing, texting, surfing, and cruising the internet instead of giving the appropriate meds and treatments! Welcome to the world of electronic medical records!,,As long a the box is checked,everything will be alright!…