The E.H.R. Error

Is Obamacare's EHR transition dead on arrival? / AP
February 28, 2014

I watched Thursday’s Care Innovation Summit. The thing I paid most attention to: HHS Secretary Kathleen Sebelius praising incentives in the 2009 stimulus for changing the landscape of medical care.

"The research tells us that electronic health records get better care," Sebelius said. "A study of Cleveland adults with diabetes, published in the New England Journal of Medicine, for example, found that patients with digital records were six times more likely to get high quality and recommended care."

"Nationally there has been tremendous progress in the last five years. Moving from quills and clipboards to computers and keyboards. When President Obama took the oath of office in 2009, one in eight hospitals were using any kind of basic electronic record… by 2012 that number has tripled. And the number of doctors now using electronic health records is up over 50 percent and on the rise."

Sebelius is painting an overly rosy scenario. Numerous hospitals and health officials sent her a letter last week expressing concerns over the timeline of the Electronic Health Records (EHR) transition. A recent survey found that the majority of physicians find the program burdensome.

EHR is simply "a digital version of a patient’s paper chart." They used to go by EMR, or Electronic Medical Records. It’s the same thing. If you’re not familiar with them, you’re probably not alone.

It’s relevant because the Center for Medicare and Medicaid Services (CMS) has a program called the Medicare and Medicaid EHR Incentive Program. The goal of it is to switch health care professionals over to these electronic systems.

The program began in 2011 and was originally allotted $20.6 billion, as a part of the HITECH Act within the 2009 Recovery Act.

The program has three stages that are supposed to play out by 2016. But it has already run into problems. The biggest problem is that those in the medical industry aren’t pleased.

While Sebelius offered a credible study in her speech, it appears she was referring to one published in 2011, with the study actually occurring from July 2009 to June 2010.

Recent developments paint a different picture.

Forty-six organizations recently asked Sebelius to delay parts of the program and extend the timeline for the 2014 technology, saying that otherwise many hospitals and health care professionals would lose incentive payments and face "significant penalties."

A survey released earlier this month in Medical Economics found that physicians are unhappy with the systems they’ve had to adopt. Instead, "70 percent of physicians say electronic health record (EHR) systems have not been worth it," and two-thirds of doctors say they "would not purchase their current EHR system again because of poor functionality and high costs."

Initially, the program was touted as a great idea that would save the health industry billions of dollars in part because of research produced by RAND Corporation. That same organization released a report  2013 saying their predictions were "overly optimistic" and electronic health records had "mixed results" when it came to "improving efficiency and patient care." Oops.