Transcript The Two Faces of Electronic Health Records

The Promise and
Peril of Electronic
Health Records
Cari Weishaar
Final Project
12/8/11
Health care costs are too high…
2009 Total Health Expenditure as % of GDP
20.0%
18.0%
16.0%
14.0%
12.0%
10.0%
8.0%
6.0%
4.0%
2.0%
0.0%
Source: OECD 2009
…and quality metrics are not
better than other countries…
“…IT must play a central role in the
redesign of the health care system
if a substantial improvement in
health care quality is to be
achieved in the next decade.”
- Institute of Medicine, Crossing the Quality Chasm 2001
Benefits of EHRs
• Safety – Decision support tools can prevent
adverse drug events caused by mistakes in
prescribing
• Efficiency – Patient information is better tracked
thereby preventing redundancy of tests and
procedures
• Effectiveness – Automated reminders can make
physicians and their patients more compliant
with treatment plans and preventative care
recommendations
EHRs are made of many silos…
Practice
Management
System
Appts
Billing
Electronic
Medical
Record
Legal Record
of Pt
Encounter
Decision
Support Tools
ePrescribing
Labs and
Procedures
Patient Portal
Encounter
Summary
Lab Results
Secure
Emailing
…with only one interface.
EHR Interface
EHR Interface
Interoperability
ePrescribing
Secure
Emailing
Appts
Legal Record
of Pt
Encounter
Encounter
Summary
Billing
Labs and
Procedures
Lab Results
EHR Adoption Rates Among
Physicians
Why aren’t adoption rates
higher?
• Misaligned incentives
• Cost are incurred by the individual practices, benefits are diffuse
• EHRs are expensive to maintain
• Resistance to change
• Learning to use the system is time consuming
• Clinicians don’t want to be data managers!
• Uncertainty about the future
• Standards are still evolving
• Too many choices (83 CCHIT certified Ambulatory EHRs in 2011)
Appendix
HITECH Funds
• Incentive payments for meeting “meaningful use”
• ePrescribing
• Electronically exchange information
• Clinical quality measures
• Reduced Medicare/Medicaid reimbursement by 2015
providers who do not meet meaningful use
• Finding for education, training and research
Small practices are lagging
Physician EHR Adoption Rates (July 2011)
80.00%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%