May 31, 2007

EHR data-sharing…not

Filed under: — mlazoff

The business technology magazine Information Week’s recently published article, Why Progress Towards Electronic Health Records (EHRs) is Worse Than You Think, provides a computerphile’s perspective on medicine’s slow adoption of health information technology (HIT). ”Despite several years of concerted national effort, including President Bush’s rallying cry in 2004 to get most Americans on e-health records by 2014, the use of digital records is at a precarious place. Just 10% of doctors’ offices use them. And while hospitals are expanding their use, the most difficult work—the exchange of data among health care providers, especially with rivals—has barely begun. Technology itself has caused problems…[t]here are legal questions, privacy issues, and competitive pressures surrounding the technology, as well as concerns about return on investment. And data-sharing practices have yet to be widely tested in the real world…There’s the occasional clear success, like a long-running Indiana data exchange. There’s also growing interest among big employers to give personal health records to their employees, though it’s not clear how those private efforts will mesh with the efforts of regional health information organizations, known as RHIOs.”

The lengthy, sober article goes on to discuss the technology and financial issues that plagued the failed RHIO in California’s Santa Barbara County Care Data Exchange; the success of Indiana’s over 30-year-old centrally administered RHIO and the newer Massachusette’s peer-to-peer network RHIO; the data sharing and EHR efforts from already-integrated health systems such as Pennsylvania’s Geisenger Health, and Kaiser Permanente; and the hope for several new projects throughout the country. The article notes that the high cost of implementing EHRs is being addressed by the federal government. Not everyone  interviewed for the article agrees that financial incentives alone will overcome the lack of urgency and unwillingness to share data that currently hampers the widespread adoption of EHRs by physicians.  

The article shares some predictions. “While it’s good for people to use personal health records they create or employees provide to guide their care, [Karen] Bell [MD, Director, Health IT Adoption, Office of National Coordinator for HIT] says, the biggest benefit comes from doctors having data access to reduce mistakes, eliminate costs such as redundant tests, and improve quality of care. But don’t hold your breath. ‘It’ll be a good 10 to 15 years before we see volume’ adoption by doctor practices, Bell predicts.” 

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