Digital divide plagues slow e-health records rollout

EHRs can sometimes be the difference between life and death

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For physicians and hospitals that do roll out EHRs and prove that they are engaged in "meaningful use" of the systems, billions of dollars in reimbursements are available over the next decade. But they must pay upfront for the systems before receiving the reimbursements.

EHRs improve health care

Electronic records not only allow general practitioners and specialists to document and easily share patient information; they also help support "evidence-based" medicine. That allows physicians to treat patients using best practices derived from the systematic, scientific study of standard treatments. For example, it's been known for years that patients should be prescribed aspirin after a heart attack, but there is currently no way to make sure that happens.

A sepsis alert system that Methodist North Hospital (MNH) implemented more than two years ago in conjunction with its EHR database has helped save as many as 4,000 lives. The Memphis hospital's EHR system alerts doctors and nurses to patients suffering from sepsis, an often deadly infection that can be difficult to diagnose in its early stages. The hospital's system includes three adult-care facilities that also use the sepsis alert system.

Paula Jacobs, director of quality and performance improvement at MNH, said the early detection technology has reduced sepsis deaths by 17% year over year, or by about six patients every month at the 280-bed facility.

"You're talking about having access to up-to-date protocols so that the right procedures are followed. The other thing is informing the consumer [through access to personal health records and electronic alerts] so that he or she knows what's being done so they can ask more questions and more likely follow the right treatment regimen," Perot said.

By 2014, the federal government wants more than half of all health care facilities to use EHRs. Physicians who implement EHR systems can get as much as $44,000 to help defray technology costs; a typical 275-bed hospital would be eligible for approximately $6 million. But clinicians and facilities must show they're using EHRs in a meaningful way beginning in the government's 2012 fiscal year in order to qualify for a full incentive payment. Hospitals that do not meet federal guidelines by 2015 face Medicare reimbursement cuts.

EHR systems would also improve the lives of physicians by allowing them to access and share patient records, including radiological images, from remote locations and through mobile devices. EHRs would also free them up from administrative tasks.

"It's complicated, but at the same time we feel so strongly that our communities benefit from this technology, and that's why we're pushing so hard," Perot said.

The federal government would also be able to better track who has health insurance to get a better view of what's needed in terms of federal supplemental medical coverage under the Affordable Care Act, which took effect last month.

Perhaps most important, by mining data from EHRs, the government and physician groups can more quickly and accurately pinpoint health issues associated with poor and minority populations -- as well as the treatments that are most effective, according to Craig Le Clair, an analyst at Forrester Research.

The SaaS option

Le Clair said that he believes a software-as-a-service (SaaS) EHR model would be the most cost-effective and least complicated deployment for medical practices, clinics and hospitals unable to afford in-house IT equipment. He said government efforts to spur adoption in rural and underprivileged areas should focus on funding SaaS-based deployments.

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