Wednesday, August 08, 2012

Electronic Health Records, by guest author Cheryl Jacque

Cheryl Jacque regularly contributes to the online resource, which offers visitors information on the health administration field, including recent changes to laws and policies. Here, Cheryl discusses how technology in general, and electronic health records (EHR) in particular, are a major aspect of the Affordable Care Act, a topic the Internet and World Health blog noted in 2006. Although the healthcare industry may struggle to move from a paper record system to a digital format, the cost benefits passed on to patients may be worth the effort.

Technology’s Role in the Changing Nature of Healthcare Administration

Healthcare in the United States is tremendously expensive, both for patients and service providers like hospitals and insurance companies. Government leaders have long been looking for a way to lower the cost of care without compromising on its quality—a difficult task to say the least.

No matter what side of the political aisle one stands on when looking at healthcare reforms, one thing is undisputedly true: implementing technology has great money-saving potential. Digitizing health records, using radio frequency identification tags for triage patients in hospitals, and computerizing pharmaceutical prescriptions and dispensations are among the many technology-based changes expected to save everyone money in the coming years.

The bulk of the projected savings will come through electronic health records, or EHRs. Traditionally, medical practices and insurance companies kept all of their patient files in hard copy, filing and copying them as needed. The world of EHRs is one in which all old records are scanned into computer databases, and new records are created electronically from the start. Ultimately, these records will be stored in a centralized database such that anyone with the requisite permissions can access them, usually from any internet-connected device. This means, for instance, that a specialist can call up a patient’s complete file without having to coordinate with any other treating physicians.

The time saved can really add up over time, and is usually one of the first ways EHRs help patients spend less. “Doctors are paid by the minute, and they don't have a clue who the patients are,” David St. Clair, chief executive of health tech company MEDecision, told CNN Money in an article weighing the cost benefits of EHR transitions. “Since patient information lives in a database, an electronic health record system means patients don't need to take the time to explain medical history to new doctors. EHRs help doctors diagnose faster, significantly cut down on the time it takes hospital staff to chart patients' information, and ultimately slash the length of an average patient visit,” St. Clair said.

Accessing files with the click of a mouse also means that doctors can avoid repeating tests, and can more easily rule out procedures that have either already been performed or are unnecessary considering a patient’s complete history. This stands to save patients and insurance companies both.

In most cases, the only thing stopping the robust implementation of EHRs is their start-up cost. It is neither easy nor cheap to convert a decades-old system into something new, particularly not without at least some initial hiccups. “Fortunately, there is substantial evidence to show that while initial costs remain a concern, converting from paper records to EHR systems will ultimately reduce healthcare expenses across the board,” the United States Centers for Disease Control and Prevention says. Public health rounds on the subject can be viewed at:

Federal incentive programs established by the Obama administration will likely be instrumental to instigating the move over to EHR. The administration has authorized up to $28 billion over the next three years for healthcare providers and medical offices that plan to make “meaningful use” of digital records. “We literally can’t survive as a hospital unless we adopt meaningful use of a certified system,” Eric Lewis, chief executive officer of the Olympic Medical Center in Washington state, told The Peninsula Daily. The OMC plans to transition to digital records by the end of 2012, but is very much relying on the federal payout. Lewis estimated that the total implementation cost, including software and training, at about $7 million. “It’s a big expenditure, but we have to think long term,” Lewis said.

EHRs are usually seen as the gateway to numerous technology-enhanced savings. Not only do they let doctors see a more comprehensive view of a patient’s history, they also have the potential to revolutionize coding and billing. Insurance companies and doctors can work together to update charts with respect to payments made and premiums filed, and patients can typically access this information immediately. In many cases, disputes can also be filed—and sometimes even mediated—entirely online.

Technology changes outside of EHRs can also have dramatic impacts on the quality and cost of care patients receive in hospitals. “With the development of miniaturized devices and wireless communication, the way in which doctors care for patients will change dramatically and the role patients take in their own healthcare will increase,” the United States National Institutes of Health says. “The next decade will bring a new realm of precision and efficiency to the way information is transmitted and interpreted and thus the way medicine is practiced.”  In-office tests, portable diagnostic imaging equipment, and improved accuracy and reliability of certain screening exams means that patients can stress less about their results—and their bills.

Though investing in the tools needed to digitize healthcare is a huge financial commitment, the cost savings into the future usually justify the transition. Patients, providers, and care facilities all stand to benefit. A little bit of chaos now is, most agree, worth it for a future of efficiency and lowered expenses.


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