the promise and peril of electronic health records
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The Promise and Peril of Electronic Health Records. Cari Weishaar Final Project 12/8/11. Health care costs are too high…. Source: OECD 2009. …and quality metrics are not better than other countries…. - PowerPoint PPT PresentationTRANSCRIPT
The Promise and Peril of Electronic Health RecordsCari WeishaarFinal Project12/8/11
Health care costs are too high…
United States
Netherlands
France
Germany
Denmark
Canada
Switzerla
nd
Austria
Belgum
New Zeland0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
16.0%
18.0%
20.0%
2009 Total Health Expenditure as % of GDP
Source: OECD 2009
…and quality metrics are not better than other countries…
“…IT must play a central role in the redesign of the health care system if a substantial improvement in health care quality is to be achieved in the next decade.” - Institute of Medicine, Crossing the Quality Chasm 2001
Benefits of EHRs
• Safety – Decision support tools can prevent adverse drug events caused by mistakes in prescribing• Efficiency – Patient information is better tracked
thereby preventing redundancy of tests and procedures• Effectiveness – Automated reminders can make
physicians and their patients more compliant with treatment plans and preventative care recommendations
EHRs are made of many silos…Electronic Medical Record
Legal Record of Pt
Encounter
Practice Management
System
Appts
Billing
Decision Support Tools
ePrescribing
Labs and Procedures
Patient Portal
Encounter Summary
Secure Emailing
Lab Results
…with only one interface.
EHR Interface
EHR Interface
Interoperability
Legal Record of Pt
Encounter
Appts
Billing
ePrescribing
Labs and Procedures
Encounter Summary
Secure Emailing
Lab Results
EHR Adoption Rates Among Physicians
Why aren’t adoption rates higher?• Misaligned incentives• Cost are incurred by the individual practices, benefits are diffuse• EHRs are expensive to maintain
• Resistance to change• Learning to use the system is time consuming• Clinicians don’t want to be data managers!
• Uncertainty about the future• Standards are still evolving • Too many choices (83 CCHIT certified Ambulatory EHRs in 2011)
Appendix
HITECH Funds• Incentive payments for meeting “meaningful use”• ePrescribing• Electronically exchange information• Clinical quality measures
• Reduced Medicare/Medicaid reimbursement by 2015 providers who do not meet meaningful use
• Finding for education, training and research
Small practices are lagging1 phys
ician
2 physici
ans
3 to 5 phys
ician
s
6 to 10 phys
ician
s11 to
25 physici
ans
More
than
25
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
Physician EHR Adoption Rates (July 2011)