Enter Your Email Address to Receive a
Copy of MedicExhange Member Demograhpics

The push for health care reform is spurring discussion about the industry adopting electronic medical records.

Advocates point to the cost savings and efficiency that will occur when the medical industry is brought into the digital age. Critics worry about issues such as security and the expense of new technology. John Singleton is the head of Computer Sciences Corp.'s North Carolina operations. The Falls Church, Va., technology company has a contract to create a new, more efficient computerized bill-paying system to serve North Carolina's tens of thousands of Medicaid recipients. CSC employs about 1,200 people in this state. On one diagnosis, almost everyone agrees: Patients will be much better off when doctors and health care institutions can easily share information. But building a health information exchange to effectively share electronic health records, or EHR, is not without risk. The procedure is organizationally, technically and politically complex.

It gives rise to strong opinions on matters such as patients' rights, provider needs and the role of government. As North Carolina moves toward an overarching health information exchange /EHR system, it's helpful to consider the experiences of other countries. No matter where you are, the concept is simple: Doctors and other providers with rapid and secure access to our comprehensive health records will be able to understand and act quickly on our needs. By having better information, doctors and patients will make better decisions. This will make health care more exact, more error-free and more efficient. Leaders in Washington believe in the revolutionary potential of EHRs and health information exchanges, and they are making available hundreds of millions of dollars. The state is moving quickly through the newly minted N.C. Health Information Collaborative to turn these funds into workable programs. European countries tend to be ahead of the U.S. in implementing large-scale eHealth initiatives, starting more than a decade ago. This is in large part because making this a reality in the U.S. is a much bigger task with many more issues. However, in both Denmark and Norway adoption by general practitioners is approaching 100 percent, compared with about 20 percent here. Based on firsthand experience in Europe, we have identified these major decision points that are transferable to state projects.  Early on, for example, it's important to recognize that IT requirements need to be regularly reviewed and potentially updated. In the U.K., specifications written in 2002 are still required in 2009, even though the practice of care delivery has changed. Outdated requirements become a source of debate, which takes time and resources to resolve.

Or consider an item as fundamental as communicating with potential patients. Officials in the U.K. addressed the key issue of informed consent early in the process, giving patients plenty of advanced notice and allowing them to opt out of the system. Less than 1 percent of patients opted out. Conversely, in the Netherlands, informed consent was not addressed until much of the system was ready for roll out. Officials then sent letters to citizens asking for permission to include them in the EHR system. The consent letters surprised many, and consequently 300,000 people returned them with incomplete or inaccurate information, significantly delaying the rollout. No rollout is glitch-free. That's why the mantra for large eHealth implementations is, pilot first, then roll out incrementally. The technology will be new. There will be system errors and missing functionality. Starting small with a core group of sites willing to spend time working through the bugs will prevent major problems during later rollouts. A team in the Netherlands started with a technical pilot to make sure the new technology worked properly before moving to end user pilots. Rollout is under way now with more than 1,500 sites successfully connected to the national network. Many of these items were discussed in September at the annual conference of the N.C. Health Information and Communications Alliance. It was a good sign that North Carolina is on the right track: diligently learning from others' experience, carefully communicating with statewide stakeholders, and methodically moving forward to save money, time and lives.

Source: News & Observer

You can discuss more about EMR and related topics in our EMR Group