Electronic Health Records, Your Data At Risk

I started posting articles about electronic health and medical records in 2006 on Natural Health News.  I am not in favour of this push in the arena of cost savings in the US health system.  To date little has been shown to indicate any effective improvment in healthcare delivery or cost savings, yet most of the stimulus investment is for hardware and unproven, SAFE, software.

I discussed this issue in an interview with Dr. Katherine Albrecht back in February.

Once again we hear about electronic health records in a New York Times article -

The nation is set to begin an ambitious program, backed by $19 billion in government incentives, to accelerate the adoption of computerized patient records in doctors’ offices and hospitals, replacing ink and paper. There is wide agreement that the conversion will bring better care and lower costs, saving the American health care system up to $100 billion a year by some estimates.

But a new study comparing 3,000 hospitals at various stages in the adoption of computerized health records has found little difference in the cost and quality of care.

“The way electronic medical records are used now has not yet had a real impact on the quality or cost of health care,” said Dr. Ashish K. Jha, an assistant professor at the Harvard School of Public Health, who led the research project.

The research is to be presented on Monday at a conference in Boston. It is a follow-on study to a survey of hospitals’ adoption of electronic health records, published this year and financed by the federal government and the Robert Wood Johnson Foundation.

Dr. Karen Bell, a former senior official in the Department of Health and Human Services and an expert in health technology, said she was not surprised by the research. “Very few hospitals today are effectively using the capabilities of electronic health records,” she observed...

And from Susan Heavey at Reuters -

WASHINGTON (Reuters) Nov 20 - New electronic record systems installed in thousands of U.S. hospitals have done little to rein in skyrocketing healthcare costs, Harvard University researchers said in a study released on Friday.

A review of roughly 4,000 hospitals from 2003 to 2007 found that while many had moved away from the paper files that still dominate the U.S. healthcare system, administrative costs actually rose, even among the most high-tech institutions.

Advocates of such technology have been pushing for greater use of computerized health records to prevent costly errors and allow greater coordination among caregivers and patients. But adoption has been slow, prompting Congress to offer $19 billion in incentives as part of an economic stimulus bill.

The results, published in The American Journal of Medicine, come as the Senate presses ahead with legislation to expand access to healthcare. While the bill does not provide funds to buy necessary equipment, it does aim to facilitate their use and boost standards.

President Barack Obama has pointed to greater utilization of e-health records to help generate savings at a time when the nation's healthcare costs far outpace inflation.

But lead author Dr. David Himmelstein, an associate professor at Harvard Medical School, and his team found so far the savings are not there.

"Our study finds that hospital computerization hasn't saved a dime, nor has it improved administrative efficiency," said Dr. Himmelstein, who oversees clinical computing at Cambridge Hospital in Massachusetts. "Claims that health IT will slash costs and help pay for the reforms being debated in Congress are wishful thinking."

National government standards for many health IT products are due next month. But even with the passage of the stimulus bill's funds, many experts expect it to take years before most Americans have an electronic health record.

The researchers found administrative costs increased slightly from 24.4% in 2003 to 24.9% in 2007, with facilities that computerized the most quickly seeing the largest jump. Hospitals with the highest costs tended to be smaller, for-profit, non-teaching ones in cities, they added.

Computerized records have yet to prove more efficient "because the commercial marketplace does not favor optimal products," creating programs to focus more on codes and billing than doctors' needs and patient care, they said.

Electronic records did show some improvements in tracking the quality of care delivered in cases of heart attacks, but it was unclear if those measures actually translated into improvements in patients' health, they said.

The researchers analyzed data from the industry's Healthcare Information and Management Systems Society, hospital reports on costs incurred through the Medicare insurance program for the elderly and the 2008 Dartmouth Health Atlas, which compiles government health data.

Their study was released by the nonprofit Physicians for a National Health Program, which backs a single-payer U.S. health insurance.