Electronic Health Records


Sobering update from EHR study

By Kyle Murphy, PhD

- Prime Time Deion Sanders had one hit song, which summed up his motivation for doing his job (i.e., playing football), “Must be the money.” Unsurprisingly, recently published updates by Medical Economics from its study of electronic health record (EHR) system use have indicated that money is the prime motivator for physicians going digital. Of the doctors surveyed, 95% indicated that achieving meaningful (and receiving incentive payments) was what drove them to adopt EHR systems. In comparison, improving patient care was listed as a secondary motivation for 53% of doctors.

Let’s be honest with ourselves and admit that money is the reason most of us get out of bed in the morning. And why should health care be any different? The Centers for Medicare & Medicaid Services (CMS) EHR Incentive Programs have already doled out almost $3.8 billion in incentives to eligible professionals (EPs) and hospitals that have demonstrated meaningful use.

According to a report from McKinsey Center for US Health System Reform, the US as a nation spends more on health care than any other nation. As of 2009, the US health care industry generated $2.5 trillion, which is 17.6 % of GDP. And health care spending continues to grow while the rest of the economy is experiencing historically low growth, with outpatient care representing one of the most significant rates of growth. Should we be concerned that our doctors are less concerned with the quality of health than the healthiness of their bottom lines?

It’s easy to be cynical about the motivations for implementing EHR systems, but from the top-down the opportunity to receive incentive payments is being championed as the means to reduce health care costs with a secondary effect being an improvement in patient care. Is the reality that tax dollars are spent to improve services we pay high premiums to access adding insult to injury?

It is too early to tell what the ultimate outcome for the EHR Incentive Programs will be. Sometimes, ends do justify the means; sometimes a return on investment requires a high initial cost — you’ve got to kick start evolution somehow. However, until we experience the tangible benefits of a streamlined health care industry (e.g., more efficient hospital visits, reduced administrative and procedural costs, improved outcomes), it’s unclear what stock at present we can take from early reports of the efficaciousness of health information technology (IT) and EHRs and EHR systems especially.

For now, we are left to hope that the long-awaited arrival of Stage 2 (correction, 2014) Meaningful Use and the advent of more robust health information exchange (HIE) will mean a significant improvement in our experience of health care as a result of increased access to, and control over, our personal health and well-being.

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