Feds: Be Patient for Electronic Records Benefits

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Information technology – the ability to keep computerized records of everything from inventory to customers - has revolutionized nearly every important sector of the American economy. But health care still lags behind.

A majority of American doctors weren’t even using electronic records systems until last year.

The White House has made pulling medicine into the digital age a priority as part of its healthcare overhaul, and says its strategy is working, but it’s a big lift and is going to take some time.

CPR Health Reporter Eric Whitney has the story.

This is a transcript of Eric’s story.

Dr. Allison Kempe is a researcher at the University of Colorado. She works on keeping kids’ immunizations on track. That’s hard if children see different doctors every year.

Kempe: That happens a lot. They get seen at one site, then their insurance changes, they go to another site. So there’s a lot of potential for records scatter.

Whitney: Colorado has a place to pull all those scattered records together – a computerized central registry where any provider who gives a kid vaccine can enter that information. So if the kid shows up in a different clinic later, staff can log in to the registry and make sure they’re not doubling-up, or missing a critical booster shot.

Here’s what drives Kempe crazy: The state’s computer system is not connected to most of the ones the doctors are using. So even though a lot of clinics now have electronic records systems, they don’t update the central database – it’s just too much extra work.

Kempe: A very small minority of practices can actually automatically upload their records. Most practices are having to do double data entry, where they enter information manually into the registry.

Whitney: And if it’s not current, doctors can’t rely on the registry for a kids’ vaccination information.

This is just one small example of the digital disconnect that’s holding healthcare back, says Dr. Art Kellermann, a policy analyst with the RAND corporation. He says the ability for doctors to easily share information is the exception in America, not the rule. The result, is that the health care industry isn’t benefitting from the computer tracking that’s transformed manufacturing, retail and banking.

Kellermann: You think about, you can take you ATM card and go to any ATM in the country and withdraw money or even move your accounts from one account to another. You can’t do that with health information technology today.

Whitney: nhas published an article in this month’s Health Affairs reflecting on an earlier study that said information technology could save America $81 billion a year by making healthcare more efficient. He found actual savings scant, and that many doctors say electronic records make them less efficient.

Some of Kellermann’s criticism is valid, but some of it’s not, says the doctor in charge of leading American medicine’s digital transformation. Transferring patient information is a lot more complicated and important than getting 20 bucks out of a cash machine.

Mostashari: People talk about the ATM, and that’s seven data elements, and they charge you two-buck-fifty for shipping those seven data fields over. We’re talking thousands of data fields around things that are life and death.

Whitney: Dr. Farzad Mostashari is the White House’s National Coordinator for Health Information Technology. His office is constantly at work just getting scores of medical records systems and vendors to agree on standards – everything from how to code different diseases, drugs and procedures to sharing data.

Mostashari: We have actually these meetings on average every three and a half hours, for the past three years.

Whitney: Mostashari says the number of doctors and hospitals using electronic records has doubled in the last two years. He admits there are growing pains, but says the government’s strategy is helping.

Mostashari: It is a work in progress, and it’s gonna be hard work. But it is way, I think, too soon, to be saying, oh, this is such a disappointment.

Whitney: Mostashari says it’ll be another six years before the government’s IT strategy starts showing big savings.

He and Kellermann both agree there’s a chicken-and-egg problem. Every practices using easily compatible records systems would help patients get better care. But doctors still get paid based on the number of procedures they perform, so there’s little incentive for them to use technology to eliminate duplicative tests and stop relying on hand-written notes.

RAND’s Art Kellermann is hopeful that the Affordable Care Act’s emphasis on the quality of care will help.

Kellerman: As we shift American healthcare and start paying for value rather than volume,start paying for the best quality care and the best outcomes, rather than who does the most stuff, who orders the most tests or who orders the most consultations from other doctors. Then I think you’ll see IT becoming a tool for efficiency and high performance.

Whitney: It’ll be slow and creaky, but Kellerman says it’s gotta happen.

This story is part of a partnership between NPR, Colorado Public Radio and Kaiser Health News, an independent news service.