Healthcare IT News - September 2008 - (Page 11) www.HealthcareITNews.com September 2008 ■ Healthcare IT News 11 O m m N T R y IT IS NOT SURPRISING that only 17 percent of surveyed physicians are using ambulatory electronic health records systems. After all, the United States is spending over $2 trillion and more than 16 percent of the GDP to rank 37th by the World Health Organization on a variety of It’s about the money Newsmaker INtervIew What is the mission of the EHRA? The association provides a forum for the EHR software community to speak with a unified voice relative to standards development, the EHR certification process, interoperability, as well as performance and quality measures and other EHR issues as they become subject to increasing government, insurance and provider-driven initiatives and requests. How have you helped accomplish this mission? Along with many of my EHRA colleagues, I devote a substantial amount of time participating in and leading numerous healthcare IT and EHR industry boards, panels, committees, work groups and forums that have implications on the healthcare industry. quality and access to care measures. Such poor results using 20th century pen and paper would be surpassed through the use of 21st century information technology, such as “fully functional” EHRs, in the management of patient care. Published online by the New England Journal of Medicine on June 18, 2008, a survey of over 2,700 physicians offered evidence supporting the conventional wisdom around adoption of ambulatory EHRs. Physician use continues to increase but at a pace much slower than most healthcare experts or the public would like. Physicians surveyed believe their use of EHRs improves quality of clinical decisions (82 percent), communication with other providers (92 percent) and patients (72 percent), prescription refills (95 percent), timely access to medical records (97 percent) and avoidance of medical errors (86 percent). In addition, more than 80 percent report a positive effect on the delivery of long-term and preventive care that satisfies evidence-based guidelines. Respondents with fully functional systems – those with advanced features such as clinical decision support - reported averting a known drug allergic reaction (80 percent) or a potentially dangerous drug interaction (71 percent), being alerted to a critical laboratory value (90 percent), ordering a critical laboratory test (68 percent), and providing preventive care (69 percent). Physicians also expressed great satisfaction with their systems. of physicians utilize EHRs in the ambulatory setting. Physician resistance to EHR adoption commonly thought to be due to physician discomfort using computers appears not to be as important as financial considerations. Survey respondents cited capital costs (66 percent) and return on investment (50 percent) as barriers to adoption. In addition, 46 percent of purchasers of systems and 55 percent of non-purchasers of systems cited financial incentives as a major factor in adoption. Interestingly, about 40 percent of respondents with and without EHRs reported that protecting physicians from personal liability for record tampering by external parties may play a significant role in facilitating adoption. Lastly, large practice groups – great- Justin Barnes vice president, marketing and government affairs, Greenway medical technologies. Chairman of the electronic Health records association. regularly testifies before Congress on healthcare It issues. “ president Bush’s goal of providing all citizens with eHrs by 2014 will not be met ” by barry P. ChaIken, MD HIMSS Fellow er than 50 physicians - were up to three times more likely to have implemented an EHR than groups of three or fewer. externalities and adverse incentives So, what does this all mean to HIT marketplace? First, President Bush’s goal of providing all citizens with EHRs by 2014 will not be met and the expected improvements in quality, patient safety, and efficiency associated with EHRs will be delayed. Unless healthcare payers – insurers and the government – increase their investment in healthcare IT by raising reimbursement rates for physicians using EHRs, sluggish adoption will continue. Using the words of economists, the failure to account for the externalities and adverse incentives inherent in our employer-based healthcare delivery system presents a marketplace that delivers poor outcomes, inefficiencies and problems in access. For healthcare IT, this means that the costs of implementing an EHR accrue to the physician ChaIken see page 12 What is the main challenge of the organization going forward? maintaining the industry’s significant momentum that we have achieved during the past four plus years. EHR Certification through CCHIT, standards convergence through HITSP with the CCD, and the healthcare interoperability that we are beginning to achieve are all signs and significant milestones that we are headed in the right direction. How will you in your new role help address this challenge? It is important for the EHRA and our member companies to stay engaged on Capitol Hill and with the state governments to showcase standards-based healthcare interoperability in our communities. While we have not achieved every goal yet, we have a strong foundation to build from and interoperability successes will become even more frequent. barnes see page 12 Financial incentives key to adoption Considering the positive impact EHRs have on patient care, it is disappointing to realize that barely 17 percent CORRECTION: The headline of an article in the July issue about michigan’s Community Health Automated medicaid Processing System, or CHAmPS, was incorrect. It should have read “michigan medicaid goes for self-service.” Is ‘most wired’ survey true reflection? no “My organization has several hospitals that are on the top 100 list, and our usage of technology is certainly not integrated. Our clinicians would not give us the top 100 designation.” – Tom Coppa Iowa Health System Des Moines, Iowa corrections Healthcare IT News is published by MedTech Publishing Company, LLC, which is solely responsible for its editorial content. Editors are expected to meet the highest professional standards for accuracy, objectivity, fairness and independence. Errors of fact are corrected as soon as the error is established and corrections are published in the medium in which the error appeared. Inquiries or disputes about the factual accuracy of the record should be directed to the editor. news best practices for all to improve business performance through the use of IT.” – Rick Warren, VP & CIO Allegiance Health Jackson, Mich. HealtHcare it newsmonitor Q 80% 60% 40% 20% 0% yes moNItor editorial independence Healthcare IT News is published in partnership with the Healthcare Information and Management Systems Society (HIMSS). HIMSS members are eligible to receive Healthcare IT News and related publications – both in print and online – as a benefit of membership. With the exception of the HIMSS Insider, which is produced by the staff of HIMSS and appears within the pages of Healthcare IT News every month, HIMSS and its leadership exercise no control over the editorial content of the newspaper and related publications. “I think it helps, but it is not conclusive. Certainly the organizations on the list are best prepared to be among the best IT-using institutions, but having the ability and using it effectively are distinctly different.” – Bruce A. Douglas Providence Health & Services Portland, Ore. “I think more work correlating to other nationally recognized tools like Thomson’s 100 Top Hospitals and Premier’s Top 100 would add credence to the survey. There will always be special circumstances around any one hospital, but we should be trying to find and share evidence-based “To the extent to which individual hospitals answer the questions truthfully, the survey does seem to identify those hospitals that are moving in that direction.” – Mark Tepping, CIO Bridgeport Hospital Bridgeport, Conn. The annual “100 Most Wired Hospitals and Health Systems” survey was criticized recently by some as little more than a marketing tool. Do you think the results truly reveal the best ITusing healthcare institutions? 169 reader responses 65% 35% no yes “Although the 100 Most Wired list can be used as a marketing tool, it actually does recognize hospitals and health systems using information technology in creative and beneficial ways. Aren’t most recognition lists and awards used as marketing tools in some form or fashion?” – Tom Long Texas Health Resources Arlington, Texas “We’ve taken the survey and the questions To take future surveys, subscribe to our enewsletter, HealthcareITNewsWeek, or visit us daily on the Web at HealthcareITNews.com. asked do a good job of assessing the state of an organization’s technology.” – David Ginn, IS Director Katherine Shaw Bethea Hospital, Dixon, Ill. http://www.HealthcareITNews.com http://HealthcareITNews.com
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