Electronic Medical Records A Disappointment In The USA
Editor's ChoiceMain Category: IT / Internet / E-mail
Also Included In: Public Health
Article Date: 13 Jan 2013 - 11:00 PST
email to a friend
printer friendly
opinionsElectronic Medical Records A Disappointment In The USA
| Patient / Public: |  |
|
| Healthcare Prof: | |
5 (3 votes) |
| Article opinions: | 5 posts |
Electronic medical records arrived with a fanfare in 2005, promising huge cost savings, better accuracy and efficiency - most health care professionals and authorities have been disappointed, stating that systems overall are not user-friendly and badly integrated, says a new report issued by the Rand Corporation, a non-profit organization.
The authors of the new report state that the potential of health information technology to reduce spending as well as improve patient care will never materialize if health care providers do not reengineer their processes to focus on the benefits that could be achieved.
Dr. Art Kellermann, senior author, and Paul O'Neill Alcoa, Chair in Policy Analyziz at Rand, said jointly:
"The failure of health information technology to quickly deliver on its promise is not caused by its lack of potential, but rather because of the shortcomings in the design of the IT systems that are currently in place."
A team of IT experts from Rand Corporation in 2005 published an analysis that predicted "widespread adoption of health information technology" that would eventually save America over $81 billion in better delivery and efficiency of health care annually.
Today, seven years on, the evidence about the efficiency and safety of information technology in the USA is far from compelling. Annual healthcare spending has rocketed upwards by a whopping $800 billion every single year!
Co-author Spencer S. Jones, and Kellerman concluded that a much more compelling vision is required to attract funding into health information technology. They offer the following suggestions:
- For health information to work properly, it needs to be stored in a single IT system and be easily retrievable by others, including physicians and hospitals, who belong to other health systems. The authors stress that this is vital, especially in emergency situations.
- Patients should by right have easy and ready access to their electronic health information, in the same way a bank customer has access to his/her account data. Patients must be able to see their own records, share them with doctors and other health care professionals and providers of their choice.
- Health information technology systems must be geared towards making a doctor's job easier and more efficient. If all it does is add to his/her workload, it is a complete waste of money and time. Systems should be user-friendly, which the authors describe as "intuitive". Busy health care providers should be able to use them easily without having to attend extensive training programs.
Physicians and other health care providers should be able to use systems across different health care settings with ease, in the same way a consumer drives various models and makes of cars.
Learn from other countries, say some experts
Some say that the USA should liaise with other countries which have successfully created and implemented electronic health care records systems in a big way nationally, such as the United Kingdom.Professor David Blumenthal of Harvard University, and Dr. Jenniffer Dixon, of the Nuffield Trust, UK, stress that in technology, organization and financing, the two nations could learn a a lot from each other. They said "Comparing health reforms in the USA and England seems to be an unlikely project: many people in both countries view the other as having a pariah health system that is not to be copied in any circumstance. But both countries are under pressure to get more value out of health care spending and reduce growth in expenditure to sustainable levels, and are consequently experimenting with new ways to encourage clinicians, patients, and institutions to help achieve this."
Several studies have looked at the benefits of electronic health records, with mixed results:
- Researchers from Weill Cornell Medical College reported in the Journal of General Internal Medicine that doctors who go digital provide considerably better healthcare, compared to those who do not.
- A team from the RAND Corporation wrote in the American Journal of Managed Care that electronic health records usage has only had a limited effect on improving medical care quality in hospitals in the USA.
- Northwestern Medicine researchers reported that patients who are at high risk for CVD (cardiovascular disease) are more likely to receive a prescription medication for cholesterol-lowering drugs when their doctors use electronic health records. They added that those patients are also more likely to achieve lower long-term cholesterol levels. They reported their findings in the Journal of General Internal Medicine.
Written by Joseph Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
Arthur L. Kellermann and Spencer S. Jones
doi: 10.1377/hlthaff.2012.0693 Health Aff January 2013 vol. 32 no. 1 63-68
MLA
20 May. 2013. <http://www.medicalnewstoday.com/articles/254887.php>
APA
http://www.medicalnewstoday.com/articles/254887.php.
Please note: If no author information is provided, the source is cited instead.
Visitor Opinions (latest shown first)
The system is not broken
posted by Dan on 20 Jan 2013 at 7:00 amI am concerned that every comment we see describes the healthcare system as broken. Do we see the delivery of petroleum to the gas pump as broken, or the cost of tires for a car? No, we see that as the cost of supplies and materials in a country that operates on the principle of charging the most for products and services that the market will tolerate.
That is what is happening in medicine. We have the idea of "Life, Liberty and pursuit of happiness" as being ingrained in the philosophy of our leaders in government. These words are meaningless in our current governmental model and the inefficiency that medicine reveals in EVERY aspect of care has someone turning a crank that prints money behind the curtains.
So healthcare is not broke. Google "Gray Market Pharmacies" and see what is happening. We live in a society that has many people making uncountable billions on inefficiency, scare tactics, artifice in "Cliff Psychology" and fear mongering.
It is the American way.
Model failure
posted by Grant on 15 Jan 2013 at 5:22 amNone of this is too surprising; what went wrong was the overselling in the first place. IT systems are just that: IT systems. Until they are built to support clinical processes and so become part of the clinical process, they will fail to produce big gains.
Further, until clinicians and politicians can make common cause around the need to share selected clinical information between systems (using open standards of one type or another) then the Primary care clinicians' records are not going to be much use to the hospitals and vice versa.
Also, there was and still is a general failure to understand that an electronic record is collected for a particular purpose, and simply having an EMR doesn't guarantee much added value. Hence the need to work out what should be selected for sharing beyond the record domain to be useful to other clinicians. You quickly then come to realise that viewing is the principal task in sharing records, and indexing those views is the thing that holds it all together. That task doesn't sit well in a competitive world.
You can't fix the doctors
posted by Marthalynne Webb on 14 Jan 2013 at 1:00 pmI am a medical transcriptionist. Congress/Medicare or whatever bureaucracy destroyed a healthy business - mine. The hospitals and offices think they are saving money. Wait till the lawsuits start. Sandra Adams, above post, was correct. The misinformation in charts - (mine, too) is a case for malpractice. Here's a list. Fix this Congress.
1. Dictators (doctors, FNPs, PAs) speak so rapidly that they are basically skipping over the words. They do not enunciate. When a 5-syllable word comes across as 1 syllable, it is lost. We must leave a blank. per-cu-ta-ne-ous (percutaneous) comes across as "pics."
2. Dictators mumble, yawn, eat, sneeze, snort, and yes, they even pass gas while they are dictating.
3. Dictators frequently work somewhere like the emergency room where loud voices, hospital PA system, ER radio, and the copy machine make it difficult to to impossible to understand them.
4. Dictators lay their mikes down and then turn away from them to dictate. Hello?
2. ESL dictators can be easily misunderstood. Chinese, Korean, Middle-Eastern, Hispanic, Russian, you name it - many, however, are better dictators than Americans because they realize their accent can be misleading. Most slow down and enunciate. Bravo and thank you!
With the above in mind, now try to understand how this translates to a "wreck a nice beach" (recognized speech) system or what is called "back-end speech recognition." The transcriber gets a document that has been dictated by a caregiver to the computer and the computer types it. Without professional medical transcribers most caregivers would be sitting in the courtroom along with the hospital corporations who used these systems. Here's one - "Dr. Defecating on [patient]. Mistakes in medications, body parts, and diagnostic studies are the norm.
A computer cannot think. It does not know the difference between "peroneal" and "perineal" and of course the doctor says "pairnel." FYI, the former is in the leg, and the latter is the crotch. A human knows what part of the anatomy is under scrutiny and can apply the correct word. Computers cannot.
Medication spellings are much too similar to depend on the computer. A mumbler's speech may indicate any of a list of drugs because they do not enunciate (or cannot pronounce the drugs).
Doctors and other caregivers are not English lit majors. They do bodies. Most cannot pronounce, let alone spell, the drugs they mention. Grammar and syntax are nonexistent.
Personally if I go to the doctor, I want that doc looking in my eye. I already know he cannot spell. Drop-down menus, contrary to the techies, are a disaster. One size does not fit all in your medical record, and the doc is forced to choose the "lesser of two evils" from a menu, or dictate, for which Medicare punishes them by fining them thousands of dollars.
I have 43 years experience in this field and I would say - "Be afraid - Be very afraid" - and no congressional panel can state otherwise. Micromanaging health records is a disaster.
A final word - if you are a health care provider contemplating or have already gone to an electronic voice system, take any money you have saved and boost your medical malpractice insurance. We can have an electronic medical record using the professional transcribers we have (i.e., keep them working for the economy?), thus putting some oversight into the system. Speech recognition is not a requirement for achieving electronic medical records. If this goes on long enough, qualified medical transcribers will all be retired, and most of America's youth do not have an education appropriate to the task.
MEDICAL TERMINOLOGY IS A SEPARATE LANGUAGE. Technology cannot do it. Let doctors be doctors. That is what they are trained to do. Poor medical records kill and maim.
astounding amount of misinformation in my medical records
posted by Sandra Adams on 13 Jan 2013 at 2:00 pmI found found an astounding amount of misinformation in my records that I have reviewed and have found there is no way to get incorrect information removed and not passed on. Also, when seeing my internist now,there is very little face-to-face contact. He spends the entire visit on his little computer reading and typing. My medication list is ALWAYS wrong. My diagnosis list is ALWAYS wrong. Like I said, there is no way to correct things. I'm told I can only write a statement as to what I "believe" is incorrect and that letter will be put in the chart. The misinformation will continue to be distributed. This is very unsettling.
Astounding amount of misinformation in my medical records
posted by Sandra Adams on 13 Jan 2013 at 1:58 pmI found found an astounding amount of misinformation in my records that I have reviewed and have found there is no way to get incorrect information removed and not passed on. Also, when seeing my internist now,there is very little face-to-face contact. He spends the entire visit on his little computer reading and typing. My medication list is ALWAYS wrong. My diagnosis list is ALWAYS wrong. Like I said, there is no way to correct things. I'm told I can only write a statement as to what I "believe" is incorrect and that letter will be put in the chart. The misinformation will continue to be distributed. This is very unsettling.
Add Your Opinion On This Article
'Electronic Medical Records A Disappointment In The USA'Please note that we publish your name, but we do not publish your email address. It is only used to let you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.
If you write about specific medications or operations, please do not name health care professionals by name.
All opinions are moderated before being included (to stop spam)
Contact Our News Editors
For any corrections of factual information, or to contact the editors please use our feedback form.
Please send any medical news or health news press releases to:
Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.
Privacy Policy |
Terms and Conditions
MediLexicon International Ltd
Bexhill-on-Sea, United Kingdom
MediLexicon International Ltd © 2004-2013 All rights reserved.
MNT (logo) is the registered trade mark of MediLexicon International Ltd.
Bexhill-on-Sea, United Kingdom
MediLexicon International Ltd © 2004-2013 All rights reserved.
MNT (logo) is the registered trade mark of MediLexicon Int. Limited.
