Tag: "EMR"

Unconnected Medical Devices Harm Patients

The federal government’s dominance of health information Technology (HIT) has been most apparent, and most harmful, in electronic health records (EHRs). However, the hand of government must lie heavily in other parts of health care, too.

An example is medical devices hooked up to patients at the hospital. Remarkably, these devices do not talk to each other, requiring nurses to waste time transcribing data from one device to another. This infographic summarizes a survey of 500 nurses commissioned by the West Health Institute:

Copyright: West Health Institute (2015)

Copyright: West Health Institute (2015)

 

These are appalling figures. I don’t know about you, but I figured out how to connect my VCR to my TV sometime during the 1980s. Medical devices are heavily regulated by the FDA. The fact that devices critical to hospital patients’ health are still not connected strikes me as a likely consequence of over-regulation.

Electronic Health Records: Here’s What Interoperability Looks Like (Not)

NCPA recently released an Issue Brief questioning the federal government’s dominance of health information technology, especially electronic health records (EHRs). Our conclusion came from the failure of the federal government to bring about so-called interoperability between EHRs. Jonathan Bush, CEO of Athenahealth, a provider of EHRs, illustrates how appalling this failure has been:

The patient’s information was in an electronic medical record, or EMR. And getting the patient’s records from the hospital to the nursing home, Bush says, wasn’t exactly drag and drop.

“These two guys then type — I kid you not — the printout from the brand new EMR into their EMR, so that their fax server can fax it to the bloody nursing home,” Bush says. (Eric Whitney, NPR)

This is not because of some inexplicable factors that cause health care to lag every other industry in information technology. It is a direct consequence of government control of IT in health care.

3 of 4 Physicians Say Government-Sponsored EHRs Not Worth the Cost

Mitch Morris, MD, of the Deloitte Center for Health Solutions discusses the results of the firm’s latest survey of U.S. physicians:

Three out of four physicians surveyed report that EHRs increase costs and do not save them time. This survey is not alone in its findings: Through another recently released survey, Clem McDonald and colleagues found that physicians say that EHRs “waste an average of 48 minutes per day.”

But those of us working with hospitals and physicians on a regular basis don’t need a survey to tell us things are not quite right. Just look at the rapidly growing profession of scribes — people who follow around doctors taking down their observations for recording in an EHR. Meaningful Use? Really?

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Hits and Misses

Government Handouts for Electronic Health Records: Standards Lowered to Ensure Money Keeps Flowing

We recently noted that, halfway through the year, only four hospitals and 50 physicians have achieved the federal government’s goals for “meaningful use” of electronic health records (EHRS). The federal government has a goal of spending $30 billion to induce hospitals and physicians to adopt EHRs, and it still has about $8 billion to spend. In order to ensure the money keeps flowing, standards have been lowered:

The new rule, released May 20 and slated to be published in the Federal Register May 23, would enable providers to use the 2011 edition of certified electronic health record technology for Stage 1 or Stage 2 in 2014. They would have the option to attest to the 2013 definition of Meaningful Use core and menu items and use the 2013 definition of clinical quality measures. (FierceHealth EMR)

So, hospitals and physician practices which received handouts in previous years are pretty much guaranteed to receive a handout this year, just by resubmitting the old paperwork.

Headlines I Wish I Hadn’t Seen

What Are We Getting for the $30 Billion We Are Spending On Electronic Health Records?

electronic-medical-recordIn 2009, the federal government budgeted $30 billion to incentivize doctors and hospitals to install electronic health records and use them “meaningfully”. Here are the results from Boston’s Brigham & Women’s Hospital — one of the leading academic medical centers in the country:

Of 858 physicians, 540 (63%) were “meaningful users”. Meaningful use was associated with marginally better quality for 2 measures, worse quality for 2 measures, and not associated with better or worse quality for 3 measures.

Meaningful use of electronic health records was correlated with better control of cholesterol in patients with diabetes and of blood pressure in hypertensive patients. The meaningful-use group provided worse treatment of asthma and depression than the non-MU group did.

HT: Ken Terry, Medscape.

Hits and Misses

Take The Money And Run? Some Hospitals, Physicians Dropping Out of Government Electronic Health Records Program

The 2009 HITECH Act authorized billions of taxpayers’ dollars be spent to pay hospitals and physicians “incentives” to adopt EHRs. The Congressional Budget Office estimates that the total tab will be $30 billion from 2011 through 2019. The Government Accountability Office has just reported on the results so far.

Not surprisingly, with so much money being spent, there was a lot of uptake: 45 percent of eligible hospitals had EHRs in 2011, versus 64 percent in 2012. For physicians and allied professionals, the share went up from 21 percent to 48 percent. However, the high net adoption rate disguises significant drop outs:

Specifically, within the 36 states that had completed their determinations of which providers would receive incentive payments for the 2012 Medicaid EHR program year, 61 percent of professionals and 36 percent of hospitals that participated in the Medicaid EHR program in 2011 did not continue in 2012. Sixteen percent of professionals and 10 percent of hospitals participating in the Medicare EHR program in 2011 did not continue to participate in 2012. (p. 23)

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Headlines I Wish I Hadn’t Seen