Achieving Healthcare Reform: The Role of Electronic Health Records

In a live Webcast hosted by Health and HumanPolicy Committee. In its preamble, the workgroup
Services (HHS) Secretary Kathleen Sebelius onstated, “The ultimate vision is one in which all
August 7, Dr. David Blumenthal, Nationalpatients are fully engaged in their healthcare,
Coordinator for Health Information Technologyproviders have real-time access to all medical
(HIT), answered critics of the Obamainformation and tools to help ensure the quality
administration’s healthcare reform efforts andand safety of the care provided, while also
underscored the role of HIT in accomplishing it,affording improved access and elimination of
stating that the adoption of Health IT will serve ashealthcare disparities. This ‘North star’
a catalyst for achieving the goals of healthcaremust guide our key policy objectives, the
reform legislation.advanced care processes needed to achieve
 “I think they are afraid that physiciansthem, and lastly, the specific use of information
somehow will be controlled by the informationtechnology that will enable the desired outcomes,
that’s in the record or by guidelines that areand our ability to monitor them.”
in the electronic record,” Dr. Blumenthal said.Health IT will play a tremendous role in the
“An electronic record, however, assemblesrealization of this vision, which is highlighted by the
for the physician all of the information that isMeaningful Use Workgroup’s early call for
relevant to be able to make an effective decision.adoption of EHRs and computerized physician
It gives them what they need to be correct andorder entry (CPOE), including time- and
wise at the point that the decision has to becost-saving features such as electronic
made. The electronic health record, by bringing alltransmission of permissible prescriptions and
this information together in one place at one timeincorporation of lab test results into EHRs.
and accessible to the physician, can advance theAccording to an Institute of Medicine report, an
patient’s health, make the system moreestimated 100,000 people die each year from
efficient and reduce premiums over time as amedical errors in hospitals. EHRs will improve
result.”patient safety reporting and data analysis and
Dr. Blumenthal cited an example from his ownprevent such errors by providing built-in safety
experience. While ordering a CT scan on a patient,management protocols and risk-assessment tools,
the computer alerted him that a similar test hadincluding early warnings and alerts. In addition, they
already been performed. In fact, “the testwill also prevent duplicate tests by reminding
had been ordered by another doctor, and as Iphysicians about preventive services.
looked at the results, I didn’t need to orderAs Dr. Blumenthal mentioned in the Webcast,
that test,” he said. “I saved the patient“Health IT can empower all kinds of
the inconvenience and X-ray exposure, and savedimprovement in preventive care, in acute care
the healthcare system the money for thatand chronic care. [The doctors] won’t miss
duplicate test.”when the mammogram is due, or that influenza
Dr. Blumenthal himself also converted from paperimmunization. We know that prevention is a very
to electronic health records (EHRs), admitting thatimportant way of avoiding healthcare costs. Finally,
it was not an easy task, both in terms ofby making sure that the administration of bills or
changing the way we are used to doing things, asof claims is more efficient, it can greatly reduce
well as from a cost perspective. However, hethe waste we all know is part of the
realized very quickly that, with more informationadministration of our very, very complicated
readily available to him, it made him a betterhealth insurance systems.”
physician. He added that the stimulus funds shouldHealthcare reform is needed, almost everyone will
make the transition easier and, if healthcare is toagree, simply because, as a nation, we aspire for
be improved through the use of EHRs, then,quality care. In fact, as President Obama said,
ultimately, “it’s the right thing to do.”“Healthcare reform is no longer just a moral
Although the healthcare information managementimperative; it’s a fiscal imperative. If we want
arena has been relatively slow in catching up toto create jobs and rebuild our economy and get
technology, physicians and others in the healthcareour federal budget under control, then we have
industry are starting to see the impact thatto address the crushing costs of healthcare this
information technology has had on otheryear in this administration.”
industries, and they are ready to utilize technologyHowever, how it will be achieved is always
as a tool as well. With President Obama’sdebatable. At least one thing is certain: that it will
economic stimulus package offering monetaryrequire a meticulous and committed approach and
incentives for adoption and use of EHRs throughcooperation between all the players in the
the HITECH Act — which qualifies hospitals andhealthcare arena. To that end, the role of health
physicians proving “meaningful use” of anIT through the use of EHRs as a major player is
EHR for $17 billion worth of incentive paymentsboth critical and inevitable at the same time. In
from Medicare and Medicaid over a five-yearterms of long-term savings as a result of health
period — the transition seems to be moreIT, analysts at RAND Corporation estimate the
achievable than before.figure to be about $77 billion a year. Hence, the
“It's an investment that will take the long,challenge lies not in its necessity — whether it
overdue step of computerizing America’sshould be done. Rather, it lies in the approach
medical records to reduce the duplication and— how it should be done.
waste that costs billions of healthcare dollars andMany have and will continue to raise myriad
medical errors that cost thousands of lives eachconcerns, whether from a technology, privacy or
year.” President Obama stated at the signingsecurity point of view. However, as stated by Dr.
of the stimulus bill on February 17.Blumenthal, “It is a journey we must take if
While the exact definition of “meaningfulwe are to improve care through the use of
use” will be determined by the HHS at theEHRs.” As we progress towards the ultimate
end of this year, the legislation outlined threevision, utilizing technology to provide secure, timely
requirements: e-Prescription, electronic exchangeand logically organized access to health information
of health information and reporting of clinicalwill become more realistic, imperative and
quality measures.ultimately meaningful. And yes, it is the right thing
On June 16, the Meaningful Use Workgroupto do.
offered its recommendations to the Health IT