Closing the HIT Generation Gap

In a previous post, I wrote about EHRs (electronic health records) and EMRs (electronic medical records) and how they should help make health care more seamless. Of course, that only works if everyone is literally on the same page, um screen.

According to the American Health Information Management Association’s journal, Perspectives, recent estimates for EHR adoption in the ambulatory care environment are just over 10 percent. Yet, the Department of Health & Human Services says that practices between 1-9 physicians account for over 80% of physicians.

I was at the doctor’s office for a routine exam today and asked him about his plans for electronic health records. He shook his head and said “it will cost over $60,000 to make the switch. I’m a sole practitioner. I can’t spend that kind of money.” He has thousands of paper records to convert, and still writes out prescriptions and referrals by hand. It’s a combination of time, money, and incentives that are holding him back, even though the hospitals he is affiliated with are already using EHRs.

There are several programs out there to help physicians like him:  The Office of the National Coordinator for Health Information Technology (ONC) is heading up the government’s efforts to help small-practice physicians adopt and use HIT.  Medicare and Medicaid have an incentive program that pays users of health information technology that boosts the value and efficiency of care provided to patients. Regional extension centers will provide technical help for providers in choosing and administering EHRs. And insurance companies are helping out too – United Healthcare, for instance, is also providing incentive payments and training for physicians that adopt EHRs under certain national guidelines.

My internist, who is a good 20 years younger than my GYN, begins each visit by opening his laptop and scanning the screen for details about my previous visit; then inputs the current vitals. He is also a sole practitioner, but knew early on he was going to use computerized records management. He’s excited about the new technology and future possibilities. I just think it’s cool that he can email a prescription to the pharmacist, and it’s waiting there for me when I arrive.

Dr. F is willing to take EHRs as far as possible. He will get support from insurance carriers, the federal government, and the State Medical Board. The Federation of State Medical Boards (FSMB) recently said that widespread adoption of EHRs by doctors will help improve patient outcomes and help assess ongoing clinical competence.

So what does that mean for you, Joe or Jane patient?

Suppose you’re a snowbird – spending winters in Florida or Arizona and summers up north. That means if a health event happens in either location, the local physician or hospital can immediately find out if you take blood pressure medication, have diabetes, or a heart condition, even if you can’t tell them.

The provider will know you’re taking certain drugs for cholesterol, for example, as well how long you have been on them and the dosage. This is important for several reasons – you might not remember all of your prescriptions, your health history, or even when your last ECG was. But they will know, and know the best treatment to provide.

Or if you are a 20-something on a ski trip in Vermont or Aspen (lucky you), and you break your leg, the caregivers can pull up your health records and know you are allergic to penicillin or have a history of migraines. That changes your treatment plan – the doctor will know to give you different antibiotic, or that your migraine medication might not mix well with the painkiller he wanted to prescribe. Potentially, this is life-saving information.

Or suppose you’re just in a different part of the city and get into a car accident? You will likely be transported to the nearest hospital, that of course, won’t have your medical records. Sure, they could be faxed over, maybe, in a while. Meantime, it makes treating you that much harder.

There’s no doubt the transition to EHRs is time consuming and costly. There is both financial and technical help available from many sources. Dr. B, there’s help out there if you want it. Old fashioned caregiving is nice, but widespread adoption of EHRs is happening, whether some doctors resist it or not.

Shouldn’t improved outcomes trump the bottom line?

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