Delinquent, delayed and diverted the electronic health records in the US are missing. According to the Washington Post two Presidents set 2014 as the target for all medical records to be electronic — so has American medicine hit the target?
According to a study by the Robert Woods Johnson Foundation US healthcare has been very slow to adopt the technology. RWJF reports 50% of office practices have a “basic” system and 59% of hospitals have at least a “basic” system (25% of hospitals have a comprehensive system). To give perspective, a “basic” system contains medical reports and medication lists but no physician notes.
Barriers stand in the way of progress:
- Medical data is a very valuable business asset. EHR companies are threatened if such data could be easily transferred to a competitor.
- Fear of losing control. Doctors and hospitals don’t want their data to be too available to insurance companies or regulators. Quality problems could be easily exposed.
- Self-determination. Health care entities want to make their own systems — the CEO would rather manage than cooperate.
- Lack of governmental action. Doctors and hospitals are licensed by States — just putting the license at risk is all that is needed to make EHRs mandatory.
- High cost of building an EHR. Every office practice and hospital needs a financial system. But, really, only one EHR is needed in a State or perhaps only one in the entire US. Hundreds of EHRs across the country is a waste of money — they all do the same thing, and they can’t “talk” to each other.
- Failure to embrace a “cloud” computing solution for a large scale EHR.
Ask your doctor:
- Please show me my chest x-ray on the computer screen in the office exam room.
- Please electronically send all my records to a specialist across town.
- Please show me a record of all the prescriptions I had filled this past year and which pharmacies filled them and how much they cost. (surely you can trust your doctor with that small bit of financial information).
- Can I send you a secure email and expect a response?
- Can you securely send me the results of my tests?
- Can you easily look up the discharge instructions from my recent hospitalization on your office computer?
- Do all the doctors and hospitals and pharmacies in town share the same medical record system — why not? It would be very good from a patient standpoint.
NO answers exemplify the current data problem. The US has a far better tax system than a medical record system and a far better post office than a medical record system. Contrary to the story in the Washington Post this is NOT OK.