Richard Reece in Medinnovation has called the Electronic Health Records initiative almost dead in the water, or at least struggling for air. Why are physicians and hospitals so slow or unwilling to join the "EHR revolution," even as it promises kickbacks of thousands of dollars to any practice that joins in the technological upgrading of health records? It could be that the transition from printed records to digital is for most practices a very expensive, labor-intensive process that is daunting to many. Another issue is that the software and hardware requirements involved are costly, buggy, and daunting to many.
The underlying truth behind less than 2% compliance, as reported recently by Forbes magzine, is security. The transport mechanism for EHR is IP -- the public Internet, in other words. The EHR initiative, in addition, did not take data security into serious consideration in its roll-out. Making things worse, the public's suspicions about a basically un-secure Internet have been increased greatly due to recent criminal hacking into government organizations and corporations; even private citizens have been hacked by legitimate organizations (News Corp) and the US governemnt is very open about its ongoing efforts to hack freely into private citizen's personal Internet data. EHR proponents get stopped on all these points, as Reece and others elaborate below:
For five years, in countless blogs, and in two books ... I’ve been saying digital medical records are a dud.
This does not mean I’m a technology Luddite, or a conservative who resists Obamacare in all of its manifestations. It means I’m a realist. For multiple reasons, EHRs simply don’t work for hospitals or doctors. For most physicians, in their present form, EHRs are impractical, unworkable, disruptive, and overly expensive without any tangible return on investment.
EHRs might work if government totally subsidized them without unrealistic “meaningful,” i.e., bureaucratic, conditions, or if EHR vendors offered them for “free” with advertisers footing the bill. But only then would they work if EHRs were useful and user-friendly.
One problem, as I see it, is theological. EHR enthusiasts see digital data in quasi-religious terms, as some sort of government electronic magic wand or Holy Grail that will transform health care into a more perfect, more tractable, more traceable system.
It ain’t going to happen. Read more.
Reece appends as proof of his conclusion a well-written op-ed written by Sally C. Pipes and posted on Forbes.com, dated July 18, 2011, which states in part:
The Centers for Medicare and Medicaid Services recently released some data that show that the digital revolution continues to evade health care.
Through mid-May, just 1,026 registered hospitals and physicians out of a possible 56,599 have demonstrated that they are using electronic medical records and other health information technology in accordance with federal standards. That’s a scant 2%.
The federal government has tried to promote the switch from paper medical records to electronic ones in hopes of improving efficiency and bringing down health costs.
It’s even putting money behind the push — some $27 billion over 10 years, or from $44,000 to $63,750 per physician and up to $2 million per hospital.
But even that vast sum of taxpayer lucre cannot will the necessary innovations into being.
Worse, like so many roads paved with good intentions, this one may yield some unfortunate consequences — paramount among them a decline in the number of doctors who will take Medicare patients.
A Rand Corporation study in 2005 concluded that health IT could save our health care system about $77 billion a year. Other studies have put annual savings in the $80 billion to $100 billion range.
The Rand study is popular with cost-cutters, but read the fine print: “much of the gains can only be achieved if all, or nearly all, of the healthcare organizations participate.”
More.