Government Technology - February 2008 - (Page 35)

Adoption Challenges Because both PHRs and EHRs aim to better manage health information by using technology, the task of assuring patients, physicians and insurers the data is secure is probably the biggest challenge to widespread adoption. EHR systems and PHRs, like HealthVault, must be proven secure if they are going to win users. McLemore said Microsoft worked with an adviser from the nonprofit Patient Privacy Rights when it built HealthVault. In California, discussion is under way to examine what role government should play in addressing these issues. California Health and Human Services Undersecretary Ann Boynton, whose technology background includes a long stretch as a consultant for IBM, said a critical step is instilling confidence in patients that the technology is secure. “We know people are concerned, and this is the challenge of privacy, security and helping people understand why something like a PHR is incredibly important. We do know that there are people who are concerned that the employer will somehow have access to their medical information,” Boynton said. “That’s a scary thing for people. We need to assure them that even if it is an employer-sponsored PHR or EHR, their private medical information is private and we have appropriate safeguards in place.” Less than two years after adoption, electronic health record systems can create enough cost reductions to pay for the cost of the systems, according to a study published in the July 2007 issue of the Journal of the American College of Surgeons. And an article in the January 2007 issue of Health Affairs estimates that the Veterans Health Administration’s Veterans Health Information Systems and Technology Architecture — known as VistA — costs $80 per patient per year. This is almost exactly the same amount of money saved by eliminating just one redundant lab test for one patient. In addition, consumers adopting personal health records may actually save money — by keeping track, they could cut down on duplicate tests and unnecessary treatments, according to the Financial Planning Association. In the case of PHRs, the issue might be more pressing because patients would be responsible for adding data to a PHR Web site. And if, for example, a person chooses a weak password, that information might be vulnerable. PHRs are managed primarily by patients, while EHRs are managed chiefly by physicians and/or health-care organizations. With both technologies, however, patients and doctors will play some role in the creation, management and storage of health information. Another difference: In a PHR, the patient is considered to own the data; in an EHR, ownership of the data is less certain. It might be argued that patients, providers and insurers could each stake a claim to an EHR. The other central challenge is widespread adoption. There are numerous electronic medical record vendors and virtually no agreed-upon standards about how these technologies ought to Microsoft’s work. So even if a HealthVault patient’s doctor has a application lets functioning EHR system users collect or a patient has found a and store health PHR application he or information for individuals and she likes, these tools may families in one not work with other place on the Web. systems. In late May 2007, the House Committee on Science and Technology introduced a bill to address this issue. The Healthcare Information Technology Enterprise Integration Act, H.R. 2406, is “intended to improve technology in the health-care system by creating a national, interoperable health IT system to maintain patient health care records. The IT system could potentially benefit thousands of people a year who suffer due to medical errors, improper diagnoses, or being prescribed incorrect medications due to lack of a comprehensive family medical history or poorly maintained records.” The bill’s sponsor and committee chairman, Rep. Bart Gordon, D-Tenn., said there’s a general consensus that fully utilized information technology would result in lower cost and improved patient care. “Regardless of its acknowledged benefits, the use of IT by the health-care community remains low and lags far behind other segments of our economy, such as financial services, banking and manufacturing,” he said. “This bill aims to remedy that problem.” In California, EHR standards are now being considered, according to Boynton, though no formal decisions have been made. She said the state is actively pursuing a strategy that will help ensure patients’ privacy as health information moves from paper to digitization. “The secretary here at Health and Human Services, Kim Belche, has established a privacy and security advisory board to look specifically at the issues around health information technology, and the factors that impact privacy and security — from a legal perspective, from a regular term perspective, from a practice perspective, the practical implications of these issues and how those factor — how we as the 35 http://www.govtech.com

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Government Technology - February 2008 Contents Point of View Big Picture The Last Mile On the Screen Products Four Questions for... CSI Effect Bad Medicine Making Health Care Personal Cashing In GIS for Less Nabbing Speedsters First Person: Records Management Chatter Box Oregon Data Centers Go Green Products Two Cents Spectrum Up Close Personal Computing signal:noise Government Solutions - Spring 2008 Power Play Double Duty Cleaning House Twice Prepared Smart Move The Path to Success Foundation for Service

Government Technology - February 2008

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