Hospitals are laging to adapt to electronic health records system
26 03 09 - 11:31
Hospitals far from paperless
By Janice Lloyd, USA TODAY
Adoption of electronic health records in hospitals lags behind previous estimates and is expected to be more costly and difficult than predicted, says a study out Wednesday in The New England Journal of Medicine.
Many medical experts agree that eliminating paper records would help save lives and make health care more efficient and less costly. But a survey of nearly 3,000 hospitals found only 1.5% have comprehensive electronic records in all units. An additional 7.6% have a basic system in one unit that includes physicians' or nurses' notes.
Earlier reports estimated the portion of hospitals adopting electronic records ranged from 5% to 59%. This survey was conducted by researchers at the Harvard School of Public Health, Biostatistics Center at Massachusetts General Hospital, the Brigham and Women's Hospital, the VA Boston Healthcare System, the Institute of Health and the Department of Health Policy at George Washington University. It had a 63% response rate and is the first reliable data, the researchers say.
To rank as having comprehensive health information technology (HIT), 24 functions were required in a hospital's major clinical units. These functions range from doctors' notes to diagnostic test images to computerized provider entry for medications. Eight functions had to be present in at least one major clinical unit for the basic program. Only 12% of the hospitals had physicians' notes.
"If we want to improve health care, I think we're really going to need to see much more widespread deployment of a lot of the key functions that are at low rates," says the report's lead author, Ashish Jha of Harvard. "Certainly in those ways it seems that we have a long ways to go."
The numbers from the survey "validated what we've been hearing," says Don May of the American Hospital Association. "We've heard some have stepped up but mostly we've heard some are on the path. They're doing a little but not enough for the whole package."
Better recordkeeping part of Obama overhaul
The study's release follows on the heels of a plan by President Obama to upgrade the record-keeping system as a key part of an effort to overhaul the health care system. Obama set aside $19 billion in the economic stimulus package to help with costs and pledged to spend $50 billion over five years.
Progress will not be easy, says David Blumenthal, director of the Institute for Health Policy and an author of the study. Blumenthal was recently named national coordinator for Health Information Technology by the U.S. Department of Health and Human Services, a post he assumes in mid-April.
"We are at a very early stage in adoption, a very low stage compared to other countries," says Blumenthal, but that suggests "an enormous upside in that respect for stimulating the adoption.
"The Congress and the administration showed enormous foresight and commitment to the goal of increasing adoption rates through the provisions of the stimulus bill," he says. "It's clear they want to see results in health care."