Future Now
The IFTF Blog
Are electronic health records really the answer to what ails us?
As soon as I saw the headline, I knew I wanted to blog about it. But work keeps getting in the way, so I haven't even had a chance to read all the way through the article in the April 23rd issue of Business Week.
Fortunately, my colleague Richard Adler, had reason to write up a summary of the piece. Here are his notes, verbatim:
"A feature story in Business Week (5.4.09) titled "The Dubious
Promise of Digital Medicine," begins by noting that health IT is being
touted as a means for increasing efficiency and reducing errors in
health care. It also notes we are about to get a lot more of it due to
the nearly $20 billion in new funding for HIT in the Obama stimulus
package.
"But, BW notes, this enthusiasm for digital technology is ignoring 'the checkered history of computerized medical files and drowning out
legitimate questions about their effectiveness.'
"The article aruges that implementations of digital medical records
have often been difficult and expensive and even dangerous at times.
Several stories about botched implementations by large medical systems
are told, and David Kibbe, a health IT consultant, is quoted as
asserting that 'most big health IT projects have been clear
disasters.' Not only have many implementations been more expensive and
more time consuming than expected, but in some cases the number of
medical errors in such things as prescription orders, have actually
increased after HIT implementations due to unforeseen incompatibilities
between existing and new systems. For example, after introduction of a
Cerner system at Childtren's National Medical Center in Washington, DC,
there was an eightfold increase in dosage errors for high-risk
medications.
"While these problems are eventually fixed, evidence remains scant
about the overall value of HIT. An article published in
HEALTH AFFAIRS in March reviewed four years of Medicare data and found 'only marginal improvement in patient safety due to electronic records.'
"Another problem that needs to be addressed is the lack of oversight
for HIT. WHile the FDA regulates drugs and medical devices, it has not
authority to regulate health IT products. This function is served by
the Certificatinos Commission for Health Information Technology
(CCHIT), a private body that, according to Business Week, is heavily
influenced by vendors.
"The article concludes that even if HIT will eventually prove
valuable, there is now great pressure--in large part from vendors who
stand to pick up new business--to move quickly to introduce systems
that are still relatively primitive."
This article evokes for me a blog post from earlier this month by e-Patient Dave on e-patient.net. From what I know about e-Patient Dave, he is pretty savvy about e-health. Yet when he went to transfer his personal health data from his health care provider's electronic medical record system to Google Health, chaos ensued. David Kibbe posted yesterday a great follow-up to this story on The Health Care Blog, entitled "The Parable of the Wicked EMR."