E-health records slow to catch on

High costs, lack of standards for exchanging data hold up national health network plans

By Heather Havenstein

February 21, 2005 12:00 PM ET

Computerworld - DALLAS -- Interoperability problems and lagging adoption of electronic health record technology are challenging the federal government's efforts to foster the creation of a national information health network, said the Bush administration's point man for health care IT last week.
Health care IT managers countered that they need incentives to offset the hefty capital investment necessary to computerize health records, as well as nationwide standards to ease the exchange of data with other health care organizations.
Speaking at the Healthcare Information and Management Systems Society Conference here, David Brailer, the country's first coordinator for health information technology, said the variability in EHR adoption by health care providers poses challenges to the goal of building a nationwide infrastructure to exchange health care data electronically.
Brailer announced that his office has formed a 100-member task force drawn from various federal agencies to analyze 500 industry responses to a request for information (RFI) on ideas for bolstering the use of EHRs. Brailer's office will release a set of guidelines for using EHRs and for building interoperability in the coming months, he added.
The RFI responses suggested that the government take a regional approach to fostering the use of EHRs and share in the cost of the technology, Brailer said. In addition, interoperability among various health care providers was a major theme of the responses.


David Brailer, the country's first coordinator for health information technology

"If interoperability is not ... built into EHRs, a generation of investment will be lost," Brailer said. Organizations purchasing EHR technology today are buying proprietary software that isn't interoperable with products from other vendors, he added.
Seeking a Standard
A director of IT applications at a large U.S.-based health system who asked not to be identified said the government needs to step up and provide a nationwide standard.
"The government needs to take the lead, [and] the vendors will follow," he said. "This should be an agreed-upon data set of what we will be sharing with each other."
Many organizations today are limited to interoperating only with health care providers that use the same EHR vendor.
The Cleveland Clinic Foundation plans to house all of the patient records for its 12 hospitals in three regional central electronic repositories that doctors can access, said Albert Edwards Jr., director of the Office of Clinical Integration and Interfaces at the Cleveland Clinic.
Because the health care provider uses clinical care software developed by Epic Systems Corp. in Madison, Wis., Davis said, "it's not a strong leap to then hit another hospital that is

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