Some things are Inevitable. You know they are going to happen as surely as you and I are destined to go the way of all flesh. In this wonderful, electronized world, we will get totally digitized. The papyrus-to-paper revolution has had a pretty good run, but the chips are gaining. We are destined to travel light through life unencumbered by paper, every record of our existence stowed in bits and bytes somewhere in the cloud.
I know Inevitable when I sense it, so I am not about to give up on electronic health records for a long while yet. Still, recent reports about electronic medical records have been rather deflating.
Last fall, a well-publicized report gave some indication that digitized records and billing codes appear to make it easier for physicians to overbill Medicare. Other studies suggest the ease of a click encourages physicians to order more rather than fewer tests. A study released this month by RAND Corp., a highly regarded research organization, concluded that to date, the technology has not offered the savings expected.
I have heard doctors say (some of them not fondly) that digitizing health records is the Holy Grail of 21st-century medicine. The quest found an enthusiastic champion in George W. Bush back in 2004. The U.S. health-care system is stuck in a 19th-century paperwork system, the president said. “Modern technology has not caught up with a major aspect of health care, and we’ve got to change that.” Bush made a promise: “Within 10 years, every American must have a personal electronic medical record. … That’s a good goal for the country to achieve. The federal government has got to take the lead in order to make this happen.…”
The president asked Congress for $125 million to get demonstration projects rolling, the downpayment for what he said would lead to reduced medical errors, improved care and lower costs.
Along came President Obama in 2009, and he pledged medical records for all Americans within five years. With all hell breaking loose economically in the country, the president’s stimulus package included $17 billion to help hospital systems and physician operations with the steep costs of converting paper records.
The presidents were bullish about electronic records for a reason. One, anyone who has seen the information-processing and storage capacity of the cheapest cellphones today can imagine the way paper documentation and folders are heading. Two, sometime in their nonpresidential lives, they must have tried to read a doctor’s scribble pad. Three, and most important, the research on the potential for savings and better patient-care outcomes was supportive.
When other countries spend a smaller share of their national treasure on health care and get results as good or better than ours, and when medical errors take out an estimated 200,000 Americans a year before their time, a president would be remiss not to take seriously a technology that promises to improve care and reduce both errors and costs.
Incidentally, one of the more influential studies that has driven the records policy was a 2005 study by RAND Corp. that projected that widespread adoption of electronic medical records could generate at least $81 billion a year in savings. In the interim, health spending has grown by $800 billion.
Is it all hype, then? Not likely. The new RAND study explains that a major reason for the underperformance is that current systems are not exactly user-friendly or interoperable, able talk to one another. Thus a patient’s records in Hospital A, for example, may not be easily accessible to doctors in Hospital B treating that patient. Hospitals and care providers also have been slow embracing change. The participation rate is far lower than RAND researches projected in 2005. And those who have ventured in are not adjusting their care procedures quickly to match the capabilities of the technology.
The savings and quality improvements are still attainable, the researchers think. But only if providers overcome their resistance, if systems are easier to use and able to communicate, and if patients can browse their health data and doctors’ notes.
Fail to take care of the ifs, and technology will march on — without the benefit to all of us of better care at lower cost.
Ofobike is the Beacon Journal chief editorial writer. She can be reached at 330-996-3513 or by email at lofobike@thebeaconjournal.com.
