HHS plans for adoption of electronic medical records

The U.S. Department of Health and Human Services last week unveiled a 10-year plan to create a new health information infrastructure that will include electronic health records (EHRs) for all Americans and a nationwide network that doctors could use to access those patient EHRs.

At a health care IT summit held by the agency in Washington, HHS Secretary Tommy Thompson estimated that the adoption of EHR systems nationwide could lower the country’s annual US$1.7 trillion health care bill by 10 per cent. He also said the use of EHRs would better protect health care records and help reduce medical errors.

Dr. Brent James, vice-president of research at Intermountain Health Care Inc. in Salt Lake City, said he thinks the savings from streamlining the U.S. health care system with EHR technology could eventually amount to US$400 billion per year. Intermountain maintains EHRs for about 1 million patients at its facilities.

But generating those savings won’t happen without a hefty upfront price tag, according to Mike Kappel, senior vice-president of strategic planning at McKesson Corp., a San Francisco-based pharmaceuticals distributor and health care IT vendor. Kappel said that he “would not find it impossible to believe” that the cost of developing a national EHR system could hit US$10 billion.

Kappel added that the federal government has budgeted only US$50 million this fiscal year and US$100 million for the next one for health care IT, meaning much of the cost burden for the envisioned new systems may be pushed out to doctors and hospitals.

David Barnhart, CIO at Wuesthoff Health System in Rockledge, Fla., said HHS needs to find a way to “incentivize” health care providers to embrace EHR technology. For example, it might speed adoption if insurers paid a premium to doctors and hospitals that agreed to take part in the new network, Barnhart suggested.

In its “Framework for Strategic Action” plan, HHS recognized the need for such incentives. According to the plan, the Centers for Medicare & Medicaid Services is considering authorizing extra payments to health care providers that use EHRs, as well as other steps designed to stimulate adoption.

The HHS plan also calls for development of standards-based EHR systems, and three industry groups representing health care providers, insurers and IT vendors announced a joint initiative to certify EHRs. Taking part are the American Health Information Management Association, the Healthcare Information and Management Systems Society and the National Alliance for Health Information Technology.

James said vendors need to pay strict attention to standards for the use of EHRs to become widespread. He added that they also need to improve existing interfaces between EHR systems and other applications. Currently, users can spend as much money developing their own system-to-system links as it costs to buy EHR software, James said.

Terry Hsu, CIO at Evergreen Healthcare in Vancouver, Wash., also called for better user interfaces on EHR systems, saying the ones now being offered by vendors “are not quite there yet.”

Elizabeth Prewitt, a lobbyist for the American College of Physicians, said a bill introduced last Wednesday by Rep. Patrick Kennedy (D-R.I.) would go a long way toward helping to pay for EHR installations. The bill calls for US$5 billion in funding for health care IT from fiscal 2005 through 2008, with roughly half of that allocated to development of information exchanges based on EHR systems.

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