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For decades, health care has lagged behind other industries in embracing Information Technology (IT). Now, The Department of Health and Human Services (HHS) has chosen David Blumenthal, MD, to lead Healthcare IT efforts for the administration.

Dr. Blumenthal, a Harvard Medical School professor who is also the director of the Institute for Health Policy at Massachusetts General Hospital in Boston, will be in charge of $19 billion in stimulus funds earmarked for healthcare IT.

Healthcare IT, specifically The Electronic Health Records (EHR) is an electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports.

The EHR automates and streamlines the clinician's work flow and it also has the ability to generate a complete record of a clinical patient encounter - as well as supporting other care-related activities directly or indirectly via interface - including evidence-based decision support, quality management, and outcomes reporting.

According to a JAMA study, 180,000 people die each year partly as a result of medical errors. Midland Memorial Hospital (MMH) in Midland, Texas, released a study that documented major clinical improvements following the full implementation of an EHR system. The study reported that after launching an EHR there was a decline in patient deaths, deaths among heart attack patients declined 27 percent, and inconsistencies associated with medication administration fell from 33 percent to about 13 percent.

Obama's Promise of 'Change' to Touch Healthcare IT

The U.S. had been slow to direct EHR development through a federal structure and relied on efforts within the private sector. However, with the funds earmarked by the Obama administration the major barrier to EHR adoption; the high cost of hardware, software and communications systems, will soon drive the implementation of a national IT system under the coordinated efforts of Dr. Blumenthal.

Supporters of EHR say electronic records will reduce overhead, improve communication and cut down on medical mistakes. Implementing electronic systems could also create thousands of jobs in software engineering, hardware sales and IT support.

But while medical experts are encouraged by the stimulus money, they're also cautious: Creating effective, efficient electronic systems will require a coordinated effort in a fragmented health-care industry.

"The problem in health care is that it's still very much a cottage industry," said Sam Karp, vice president of programs at the California HealthCare Foundation in Oakland. "Just adding computers won't change the way physicians practice -- they need to network with other physicians, labs and pharmacies."

California's share of the economic stimulus money could add up to $3 billion for health IT, according to the HealthCare Foundation. But that money reimburses doctors for systems they've already bought, instead of giving them money upfront to make the initial investment. Additionally, physicians and hospitals must demonstrate "meaningful use" of an electronic system -- which means they can't just enter patient data into a computer, but must also use the computerized data to communicate with other providers -- to qualify for reimbursement.

At the moment, there's no common platform for information exchange. Because each electronic record codes information in its own way, most systems can't communicate. Even if two practices purchase the same software, they don't necessarily use the same coding database, said Paul Tang, chief medical information officer at the Palo Alto Medical Foundation.

"It's like you have two Microsoft Words, but one is communicating in English and the other is communicating in French," Tang said.

Is EHR a Panacea?

Physicians switching from paper to silicon also confront major logistic and financial hurdles. In addition to purchasing an electronic record system, doctors must buy computers, install a local-area network, customize the software and train their entire office staff. Not to mention the task of scanning old records, which alone can take months.

As medical director of the O'Connor Family Health Center in San Jose, Dr. George Kent has spent the last 18 months helping the clinic transition to an electronic system. Converting O'Connor Hospital's three outpatient clinics to electronic records cost roughly $250,000 and involved "an army of people," Kent said, from computer programmers to data entry staff.

"We had to cut down to half our clinic load for three months," Kent said. "There was a backlog in patients and our revenues went down -- it was initially very inefficient."

Although he doesn't regret the investment, Kent cautions against thinking of electronic records as a panacea.

Source: Postbulletin/Health Examiner