In 2003, President Bush said he wanted most Americans' medical records to be computerized within 10 years. Five years later, only a third of Texas physicians surveyed by the Texas Medical Association are using an electronic medical record system, up from 27% in 2005. Some physicians worry any system they buy may be incompatible with those used at other physician offices or hospitals, eliminating much of the benefit of having records that can be easily shared. But other medical professionals say they can't imagine working without an electronic record system.
With a recent study showing that as many as 7,000 people are killed each year by faulty prescriptions based on illegible handwriting, an increasing number of doctors are trying to avoid problems by using a handheld computer to send prescriptions straight to the pharmacy. Five medical associations are urging their doctors to use e-prescriptions, and in April the Pharmaceutical Care Management Association, a national association of drug plan administrators, started a national ad campaign to promote the practice.
The PCMA, which supports legislation that would require e-prescriptions in Medicare, claims it could prevent as many as 1.9 million medication errors and save the federal government billions of dollars over the next decade. Experts predict that by the end of this year, about 85,000 doctors nationwide will be writing e-prescriptions.
"Hillary Clinton has no idea how an electronic medical record works!" That came from an audience member weighing in on the appropriate government role in facilitating the adoption of healthcare IT at last week's Towards the Electronic Patient Record conference. The 24th annual TEPR event drew to Fort Lauderdale its usual assortment of IT wonks, curious physicians, and overzealous sales people. Scattered among them were innovators with substantial stories to share. The open forum on what the next president should do drew an equally motley array of commentary, including the Clinton naysayer's. Her point, however, was that few elected officials understand the industry's need for clinical IT, and that education is in order. No one disputed that point, although ideas on how to make such schooling possible were in short supply.
Any elected official who happened upon the forum might have been puzzled by the lack of consensus on the industry's willingness to change. Citing the almost mythical physician resister, one outspoken commentator insisted that an entire generation of older physicians needed to die before any progress can occur. I could just hear a Hillary Clinton listening to that, and wondering, "Now let's see, you want how many billions for this healthcare IT, but you won't be able to put it to use until at least one generation of physicians leaves this planet for keeps." There was a pro-physician rebuttal, luckily, as a practice manager duly observed that until the technology "disappears"—meaning when it becomes a seamless part of the doctor's workflow—physicians will likely continue to balk at its use. Age is not the factor, he said, but rather priorities.
TEPR's tireless champion, C. Peter Waegemann (who serves as CEO of the Medical Records Institute, the event's sponsor), did a nice job of fielding and synthesizing the numerous comments, even when his 60-second speaking rule was ignored. I swear, one reason there has been so little political support for clinical IT is the inability of industry proponents to make a case in anything less than 10,000 words. An open forum always runs the risk of becoming Grandstanding Central.
The broad role that IT plays in daily life was not lost on this crowd. During the conference, I heard multiple references to YouTube, MySpace, and online banking services, all of which have captured the imagination of the public in ways no one could have predicted. Inevitably, these references were couched in a bit of awe, at the sheer popularity of these online services, and also a bit of mystery—why does healthcare struggle for comparable uptake?
We heard from Microsoft's James Mault, MD, on that score. Mault described the software giant's vision for a "health ecosystem," meaning an online personal health record service that consumers will control. In his view, consumers will drive the data exchange and consolidation that people like Waegemann have been promoting for years. And indeed, there were vendors on the exhibit floor selling flash drives designed to house clinical data for consumers to tote from caregiver to caregiver. Even if Hillary Clinton has no idea how that kind of medical record would work, she is not alone. The industry itself is a long way from figuring it out.
Gary Baldwin is technology editor of HealthLeaders magazine. He can be reached at gbaldwin@healthleadersmedia.com.
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The Certification Commission for Healthcare Information Technology has certified two more ambulatory electronic health records systems under its 2007 criteria. The new certifications are for Record UE Version 4.5 from Atlanta-based MedcomSoft Corp., and Sevocity Version 5.0 from San Antonio-based Conceptual Mindworks Inc. CCHIT has certified 31 systems under its 2007 criteria, which is no longer open for applications.
CINA
will assist HealthBridge, one of the nation's largest community Health Information Exchanges, in a data extraction and aggregation project to satisfy the requirements of a federally funded community-wide project to be initiated throughout regions of Cincinnati, OH. This initiative will attempt to demonstrate that data extracted from physician-based electronic medical records and practice management systems throughout the HealthBridge service area can be successfully integrated with HealthBridge's own clinical data for quality improvement purposes.
The California Department of Insurance is encouraging consumers in the state to use Web-based personal health records. Despite their availability through insurers and managed-care groups, not enough Californians are using PHRs, according to a report issued by the Insurance Department. The report states that PHRs are efficient and secure, and give consumers a place to better manage their healthcare and deal with insurance claims.