Electronic Health Records Coming to a Doctor Near You

The Kaine administration has been doing some useful things behind the scenes, but because of my monomaniacal fixation on transportation, land use, energy and the environment, I have not had time to highlight the more positive initiatives. With this post, I hope to make up for that deficit to some small degree.

One of Gov. Timothy M. Kaine’s priorities has been to increase the efficiency of Virginia’s health care system by encouraging physicians and hospitals to adopt electronic health records. Until this week, none of these endeavors had resulted in anything terribly newsworthy. But on June 12, U.S. Secretary of Health and Human Services Michael Leavitt visited Richmond to announce Virginia’s participation in a Medicare initiative to promote the use of certified electronic health records (EHRs).


Leavitt thanked Kaine, legislators, members of his cabinet, and Michael Mathews (CEO of MedVirginia), and others for developing a winning application. The project, one of 12 in the country, will provide financial incentives to as many as 100 primary care physician practices in Virginia to use certified EHRs.


If there’s anything close to a silver bullet for out-of-control health care expenditures, it’s probably EHRs. Let me rephrase that. There are no silver bullets. But of all the remedies discussed, getting physicians, hospitals and other health care providers to adopt electronic records would do more than any other single thing anyone can do to cut costs and improve patient outcomes.


The U.S. health care industry has been notoriously slow to adopt electronic records. A majority of physicians still make hand-written notes, which are sometimes illegible and lead to transcription errors. Paper records also are far more difficult to share, resulting in redundant and unnecessary procedures when a patient moves to a new setting. Although systems with computerized provider order entry have existed for more than 30 years, fewer than 10 percent of hospitals as of 2006 have a fully integrated system, according to Wikipedia.

According to one 2004 estimate, one in seven hospitalizations occurred when medical records were not available. Additionally, one in five lab tests were repeated because results were not available at the point of care. “The evidence is too compelling and the stakes are too high to maintain [the] status quo,” said Mathews, the MedVirginia CEO.

MedVirginia, Virginia’s Regional Health Information Organization, is the logical group to take the lead in the Medicare initiative. Since its inception in 2001, the organization’s vision has been to create “the most electronically connected medical community in the United States.” In 2005, MedVirginia developed the capability to collect patients’ hospital, lab and pharmacy data and organize it into one single electronic chart. The key now is to get all players to use electronic records.

Medicare will begin working with Virginia in the summer of 2009 to build partnerships and develop strategies to recruit Virginia physicians into the program. It’s a shame we have to wait a full year just to start work on this important project. More.


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Comments

  1. Anonymous Avatar
    Anonymous

    “But of all the remedies discussed, getting physicians, hospitals and other health care providers to adopt electronic records would do more than any other single thing anyone can do to cut costs and improve patient outcomes.”

    Absolutely, Jim!

    In addition, adopting electronic records will make it much easier to eliminate not just honest albeit unnecessary tests, etc but also to monitor possible fraud and abuse. Every year, we lose billions of dollars to billing errors and outright fraud (estimated $70 billion in 2008).

    Two of the “biggies” are durable medical equipment, such as wheel chairs, and medical supplies, both covered under Part B. It is much easier to monitor possible abuse electronically by looking at patterns than to shuffle numerous paper bills.

    FWIW, I recently learned at a Medicare/Medicaid fraud seminar that Virginia leads the nation in investigating and recovering money in this area. There is quite an impressive group that works state and federal cases down in Abingdon. I’m pleased to see Virginia take a lead in trying to prevent such losses.

    Deena Flinchum

  2. Larry Gross Avatar
    Larry Gross

    I’ve read articles that say that the reason why this system is not being implemented is that it “costs too much” and that specifically – it costs Doctors too much.

    One doctor was quoted as saying that the folks who pay for these records are not the folks who benefit.

    It has been estimated to “cost” each Doctor about 60K to implement.

    That sounds like a lot until you think about how that cost would get allocated out to the patients over years and it boils down to a cost that is more than paid for if it results in one less unnecessary test amounting big bucks or.. in the case of others – a test not done that should have been – if the records were integrated…

    …. i.e. in short .. money saved from making wrong and expensive choices not because the information needed to make good decisions does not exist – but because it does not exist at the point where medical decisions are made when it is needed…

    .. I don’t think we should be offering Doctors “incentives” – I think this should be mandated – period.

    .. Doctors -the guys who are supposed to “do no harm” – are choosing short-term .. self-interest paths that don’t benefit them nor their patients in the longer run.

    Shame on ANY doctor who is opposed to this…

    it’s unconscionable from a patient point of view and from a public policy/health care point of view.

    I’d go so far to say that if a Doctor makes a mistake because he did not consult the available records that he be held accountable for not consulting available records.

    In other words.. do your job.

    If a patient has medical records that do exist – how can a Doctor NOT use that info in making medical judgments…

    we have a catch-22 of their own making… they choose NOT to support electronic records and then that forms the basis of their mea culpa – “I did not have access to complete records”.

    enough with the excuses.

    I’d say this should be part of the Physician Certification – a best practice that is not optional.

  3. The first benefit of obtaining medical records and immunization records is that it will allow you to properly evaluate your potential risk for developing certain types of medical conditions and numerous types of diseases. There are many types of medical problems that may occur based on genetics alone.

  4. Electronic Health Records allows patient to provide doctors with valuable health information that can help improve the quality of care that patient receives. Electronic Health Records can help to reduce or eliminate duplicate tests and allow you to receive faster, safer treatment and care in an emergency and helps to play a more active role in yours and your loved ones’ healthcare.

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