Nationwide E-Health Records by 2014?

Information Management Journal, Mar/Apr 2009

E-HEALTH

President Barack Obama has plans to standardize and computerize all health records within five years as part of his effort to boost the U.S. economy.

But experts say the hurdles are great. For example, only 8% of the nation's 5,000 hospitals and 17% of its 800,000 physicians currently use the kind of computerized recordkeeping systems that Obama envisions, according to CNNMoney.com. Workers with the skills necessary to build and implement such technology are scarce, and the cost would be great. And, finally, patient privacy must be guaranteed.

Independent studies from Harvard, RAND, and the Commonwealth Fund have shown that such a plan could cost $75 billion to $100 billion over the 10 years they think it would take to implement it.

Highly skilled health information technology professionals are rare. The greatest cost will be paying and training the labor force needed to create the network, which must be user-friendly, experts agree.

"Doctors cannot spend hours and hours learning a new system," Luis Castillo, senior vice president of Siemens Healthcare, told CNNMoney.com. "It needs to be a ubiquitous, 'anytime, anywhere' solution that has easily accessible data in a simple-to-use web-based application."

Furthermore, ensuring the privacy of patients' records in a nationalized computer network will require new laws. The Health Insurance Portability and Accountability Act does not address web records. Hackers and system failvires must be anticipated, too.

Despite the enormous challenges, a fully computerized health record system could save the industry $200 billion to $300 billion a year, said David Brailer, former National Coordinator for Health Information Technology who also served as President Bush's information czar from 2004 to 2006.

Experts say it could also help Americans by slowing their skyrocketing healthcare premiums.

"Obama's support for electronic medical records is one of the key efforts of health reform that actually will deliver lower costs for hardworking American families," said Larry McNeely, a healthcare advocate at U.S. Public Interest Research Group. "Long-term savings can't happen unless we have 21st century health information technology."

Massachusetts has developed a plan to fully computerize records at its 14,000 physicians' offices by 2012 and its 63 hospitals by 2014. After a pilot program, the state legislature estimated it will cost about $340 million to build the statewide computer system, with a cost of about $2 million per hospital.

The good news is that, according to experts, the Bush administration laid much of the groundwork for the program, resulting in several pilot programs and a standardization of medical records in a handful of states.