Electronic Health Records: Success or Failure?Before the 1960s, all medical records were on paper and filed using manual filing systems. The patient's name and Social Security number were the primary means of identifying a patient, with a provider-assigned medical record number also used as a form of patient ID. This paper-based system led to many errors, ranging from billing mistakes to issues of patient care. Until the promise of an EHR came to light, reducing clinical errors was an elusive goal.
The Beginnings of EHRIn the mid-1980s, the Institute of Medicine (IOM) commissioned a study of paper record usage. In 1991, the outcomes of the study were released and one important finding was an evidence-based recommendation for the use of EHR. In 2004, Congress passed legislation promoting EHR in the United States and President George W. Bush signed it into law. First, the government created the Office of the National Coordinator (ONC) of Health Information Technology. In 2009, the Health Information for Technology for Economic and Clinical Health Act (HITECH) was also signed into law and offered: "...higher payments to health care providers that meet 'meaningful use' criteria, which involve using EHR for relevant purposes and meeting certain technological requirements." The term "meaningful use" means that patients and physicians use the EHR to communicate and that the data is easily assimilated into another provider's electronic health record. HITECH was part of the American Recovery and Reinvestment Act (ARRA) of 2009 that was signed by President Obama. Physicians received payments between $44,000 and $66,000 for implementing an EHR. The end goal of the push for electronic health records was for there to be interoperability between systems, as doctors, hospitals, and other providers all used different systems. How well did HITECH do in computerizing patient medical records?
Benefits of Electronic Health RecordsPutting aside the issue of interoperability, the following benefits help make the business case for electronic health records:
- Reduce labor costs for filing and recalling paper records. Computerized records can be recalled in seconds.
- Medical records are easily available from anywhere, which is especially helpful to on-call doctors or a multi-office practice.
- Makes for increased legibility of medical records transferring information into legible texts, charts and other kinds of output.
- Makes it easy to notify patients individually about drug recalls and practice-wide alerts or notifications.
- Reduces filing time through the automatic posting of lab results and results from other tests.
- Cuts down filing time and handling of paper using a scanner for documents and other attachments to the patient's medical record.
- Decreases worker's time spent on filling out forms and tracking and managing diagnostic tests, laboratory tests and prescriptions.
- Mitigates time spent copying records for the unending requests for information from medical practices, hospitals, insurance companies and more.
Have We Met the Promise of HITECH?In 2009, President Obama signed the ARRA making HITECH law. The year before HITECH passed, only 17 percent of doctors and 9 percent of hospitals were using an EHR. By 2015, over 50 percent of doctors and more than 60 percent of hospitals had electronic health record systems. The goals of the first few years of HITECH was to encourage doctors and hospitals to buy and embrace electronic health records. The numbers suggest that this goal is being met. But, while patients have migrated to using patient portals and looking up test results and making appointments online, the success of data portability has not yet been met. Some organizations use legacy systems, and some use a SaaS provider for collecting and storing patient data. Because of the vast number of systems and unique requirements for electronic health records by specific types of providers, interoperability of medical health records is not yet realized. Ideally, an electronic health record automatically populates demographic and clinical information so that data is only entered one time. The information contained in an EHR is easily accessible from other EHRs, including hospitals, where it is easily read. With all patient information in one place, duplicate testing can be avoided helping to reduce overall healthcare costs and start caring for patients sooner.
Does NextGen EHR meet the promise of HITECH?NextGen EHR is one of the strongest ambulatory EHRs on the market. It makes interoperability one of it's largest priorities with their Mirth acquisition and further investments in it. They also are participant and advocate for Carequality which is getting us much closer to the original vision of HITECH than ever before.
Meeting the Promise of HITECHIs your organization not feeling the promise of HITECH? A TempDev EHR consultant can help by consulting with you on workflows, integrations, and interoperability so you can better take advantage of your investment in your NextGen EHR.
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