The Impact of Electronic Medical Records on American Health Care

The scenario is one we are familiar with yet seldom think twice about. You arrive for your doctor’s appointment and after waiting to hear your name you are summoned to an examining room. There a nurse takes your blood pressure, reviews your record and asks about allergies; noting everything in the color-coded file bearing your name.

Afterwards you walk past the receptionist and notice the massive filing cabinet sitting solemnly behind them. Filled with color coded charts just like the one the nurse had for you it dwarfs nearly every object in the office. Then you walk out and your mind turns to the next task at hand.

Imagine all of our every-day tasks being reverted back to a dependence on paper systems; some of us may still remember those days. Without online or electronic applications the added amount of processing time involved with each step can exponentially increase processing times. According to the American Journal of Health-System Pharmacy by 1999 fewer than 10 percent of American healthcare providers used electronic technology; American health care is still in the days of paper.

In his article, IT’s Role in Efficient Practice published in Healthcare IT, Neil Versel cites a Harvard Medical School study which estimated a minimum of 24 percent of all medical costs went to pay for administration. In a $4 trillion industry that equates to an astounding $576 billion just to have paperwork pushed from one place to another. To drive the point home Versel notes in 2008 the money spent on paperwork in the health care industry surpassed the budget of the U.S. Department of Defense.

As consumers we understand how the costs of transportation and fuel can affect the price of products we buy. How many of us consider the impact of administrative costs on medical care? By converting our inefficient paper systems to high-tech practice management systems and our colorful file into an electronic medical record, or EMR, we can fantasize about the impact a few billion dollars might have on the cost of healthcare. In the field of nursing, an occupation that suffers from long hours, that also equates to more work being done with fewer hours spent on paperwork.

The U.S. government recognized this potential and with the 2009 economic stimulus package it aimed to provide incentives to physicians who implement a certified EMR and can show “meaningful use”, notes a PhysiciansPractice.com article What’s in the Stimulus Plan for You. This includes added payments to those who adopt an EMR and a reduction in Medicare payments after a five-year incentive period to those who don’t. But solutions involving technology are never simple.

There are many reasons the medical industry hasn’t already adopted these systems. Interoperability, a big word for data sharing, runs into problems with software compatibility between practice management systems and health information exchange; though there are many providers they are seldom compatible with one another.

Privacy is a serious consideration. According to the L.A. Times and estimated150 individuals, from doctors to clerks require access to a single patient’s record at some point during hospitalization. Complicating matters are 600,000 other payers and entities that would require access during the process of daily payment processing. The more access points you add to a system the higher the risk for data interception.

Topping off the mix are issues of incorporating older records, the reluctance of physicians to abandon a system they are comfortable with, the legal status of paperwork (which sometimes requires reports and orders be kept in their original and unaltered form) and the occasional need for customization and the solution becomes ambiguous.

In 2005, addressing the need for standardized and compatible technological solutions, the U.S. government contracted the Certification Commission for Healthcare Information Technology to develop certification criteria. In 2007 vendors began utilizing those criteria and so progress, slow though it may be, is being made in medical administration.

Currently Britain and Canada both have projects in the works that will implement EMR and in the U.S. the Department of Veteran Affairs implemented a system allowing physicians and providers to access and update a patient’s EMR at any of the VA’s healthcare facilities.

As larger medical providers pave the way the more established, affordable and accepted these systems will become. Maybe one day you will walk into your doctor’s office and sense the enormous filing cabinet isn’t the only thing missing, so is the sound of shuffling papers, time spent in the waiting room and the hefty bill afterwards.

If you would like more information on the subject of EMR, PhysicianPractice.com offers an informative section on technology and Wikipedia.org hosts a detailed article with helpful resources and references on the subject.