Thursday, August 26, 2010

EHRs are real, but business execs may not think so

No surprises here: More than 100 IT-healthcare managers and execs, in a recent survey conducted by Embarcadero Technologies, said what worried them most about running an electronic health records system were database performance; integration of different data; and data quality. But these same executives said they are also ready for it.  

Right now, about 6% of doctors in the U.S. have Electronic Health Records (EHRs), and even fewer hospitals have them; but that’s expected to change once the new HITECH (Health Information Technology for Economic and Clinical Health) stimulus money kicks in. So why are we talking about this type of IT topic?

Because it also mentions that with more than $19 billion dollars available as part of the HITECH act, it is no surprise that close to 60% of respondents were in the process of implementing an EHR system. The HITECH Act also establishes 25 major “Meaningful Use” (MU) requirements that all electronic medical records systems must implement in order to have their users qualify for billions in government incentive money. 

So if these guys say they are ready and the dollars are behind it, why is the adoption of EHRs going so slowly?  When will we reach the tipping point? Our thought, IT professionals do not drive the business, the business people do, and they are not driving adoption of this type of "record keeping" because it is messy and complicated.  Oh, by the way, they do not have to interact with these systems to get the information they need to do their jobs, so they do not support its implementation as much as they should.  

The survey also asked these IT professionals to rank their level of agreement with areas related to “meaningful use.” Half strongly agreed or agreed that the existing information on MU and Certification and suggested their level of knowledge and technical competence was adequate to implement these systems. 

Again, this work has the potential to fundamentally change the way medicine in this country is practiced. The IT know-how is there, the money to get it started is there, so why is it not being adopted more quickly?  John Kenneth Galbraith once said, "When people are faced with change or proving why they should not change, they get busy with the proof."  We cannot help but think, all stakeholders involved with this change are kicking and screaming with their reasons to not change.  

Of course, that doesn’t mean everyone will buy the same equipment. The survey found the respondents were contracting with many vendors. Perhaps it would make sense for industry to think about vendor collaboration. Better yet, let's make all the business folks enter their healthcare data into an EHR, work with its output for several months, and then we believe adoption will grow.  

Industry will gain a good deal from the secondary use of electronic health records. Whether the information is captured at the patient level and used to help in the research and development programs or the data are gathered during a clinical trial, EHRs can help all parts of medicine, as Deloitte points out.

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