A cornerstone of President Obama’s national health system—Health Information Technology (HIT)—promises unanticipated problems. A new study by the National Center for Policy Analysis (NCPA) examines the goals and obstacles that lie ahead for electronic medical record-keeping. A new multi-faceted bureaucracy under the Health and Human Services Department (HHS) was supposed to begin in 2012 to impose mandates on doctors and hospitals to toe the line on electronic medical records (EMRs) for patients.
But it has already begun. On Oct. 5, it was reported the U.S. Coast Guard did not meet new federal standards for electronic medical records (EMRs) for its 34 clinics. So, it had to spend $14 million to award a contract for a new electronic health records system that meets federal standards dictated by rules issued by the power-loving Secretary of HHS.
If doctors and hospitals comply with federal regulations on health information technology, they will get some government bribe money. “Although some proponents discuss the perceived benefits of HIT, missing from the debate is an honest discussion of experiences with actual HIT systems,” stated the NCPA study. “The ultimate goal should be to improve quality, increase efficiency, and add convenience—not just to create wired facilities.” In the U.S. now, suppliers of pharmaceuticals and medical equipment “are often completely wired.”
Therein lies a large potential problem. Dr. Jose DeJesus, a Virginia physician, explains: “Anyone who makes a major investment in any kind of electronic medical records system had better negotiate a provision that it will be made compliant with future federal standards[.]” “Such an agreement,” continues Dr. De Jesus, “will be meaningless” if your system is out of compliance with the federal mandates,” he wrote some months ago in Physician Entrepreneur, an online publication. “Don’t assume that the federal government will pay for your system, especially anything that you invest in before official standards are announced.”
The NCPA study says electronic medical records “are not in widespread use despite being often cited as the technology with the greatest potential to improve quality and reduce costs. Two well-known estimates put the potential savings at around $78 billion annually. However, the Congressional Budget Office (CBO) found that no evidence yet exists to support claims of substantial savings from HIT. Proponents of HIT are hoping that research that uses integrated data bases of patient treatments across large populations will yield information on which treatments work best.” The study’s authors, Devon Herrick, Linda Gorman, both senior fellows, and John Goodman, president and CEO of NCPA, said, “To be effective, this would require following patients over many years.” Those spending money on HIT systems “without also investing in training and having processes that take advantage of the new technology are unlikely to fare well,” the authors said.
A potential advantage of having patients’ records stored electronically is that “distance becomes irrelevant when consulting with a physician.” But, installing HIT systems in a hospital or doctor’s office is “much more complicated” than installing software on a computer linked to the Internet. Privacy and security could be invaded by hackers, and patient data could be altered “making EMRs available to far-flung health care providers necessarily makes them accessible to the world at large.”
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