A little over a month ago, I asked our Healthcare IT News social media followers if they believed a nation-wide transition to EHRs for doctors would lower healthcare costs. From Twitter to Facebook, there was a wide range of opinions. Some said that it would help lower administrative costs, while others were pessimistic about the approach at the time because of the debt crisis deadline.
Over the course of the month many health IT professionals and onlookers shared their stories with us.
Dr. Scott A Vinci had experiences with two different EHR solutions. "The reality is, that staying current with IT in a healthcare practice is expensive!" he commented. " Work-flow, the single most important thing that allows a practitioner to be competitive and profitable, comes to a screeching halt every time there are upgrades, glitches or changes to the infrastructure."
LinkedIn member Scott McCabe responded to Vinci's comment, saying it's all about the information. "Regardless of its origin," McCabe started, "whether it is the EMR, HIM, scheduling, radiology, transcription, referral, paper or whatever form, it is about tying all of the information together by using technology that can tie these separate and disparate systems together."
He added that these technologies provide a consolidated, unified window into all of the information across the entire enterprise, regardless of its origin or source.
Apparently, this window McCabe speaks of doesn't seem to exist, though. "The EMR vendors have painted a picture that by buying their EMR software the physician will have a complete view into the patients medical record," he said. "That is not so."
An estimated 20-30 percent of information is not from the electronic medical record. This is where the health information exchange comes in (or doesn't come in). Many medical devices do not integrate with the EMR, making it difficult for the practitioner to assess the complete profile of a patient, McCabe remarked.
Multiple Healthcare IT News LinkedIn followers believe that security may be the biggest obstacle. "A major problem is the lack of security around any electronic information system," discussed Dave Frenkel, a business development consultant in Washington, DC. "As one cyber security expert put it once: your PHI is in an EMR – it is as good as being on the Internet."
Frenkel said he has been a "victim" of the U.S. government losing his personal health information. He told followers that those who think that electronic information can be kept confidential should look at the statistics of those that have been fired at the UCLA Medical Center for reviewing records of celebrities for entertainment purposes and not medical care.
But is the unification of medical data worth the overall security risk? Paul O'Hara, a healthcare and education specialist at Sprint Nextel, proposed fax machines to other followers of the thread. "How safe is your information when it is sitting on a fax machine unattended waiting to be picked up, or worse yet, sent to the wrong fax machine all together? Technology is moving us forward we must utilize yet for its advantages not bury our head in the sand for its risk."
O'Hara calls any type of information, whether it is electronic of paper, "easy prey" for anyone. Picking our battles may be the only choice.
Frenkel responded to O'Hara's comments. "Paul, the problems the Internet causes for data security cannot be under stated," he said. "Sure there are problems with paper records but it is impossible to do the privacy damage that electronic records can do when hacked or leaked."
Marvin Myers on the other hand, a frequent commenter on the group page, showed his frustration to where the conversation was going. "I have been preaching the patient safety sermon on other groups for months," he said. "Every time I do, someone comes on with a post about how there are no scientifically reproducible studies that EMR's have any effect on patient safety."
Myers maintained that all EMR studies only prove the beliefs of the researcher involved with the study, claiming that including or excluding certain results can easily manipulate statistics. One can see the frustration in Myers' post; something that seems to have been haunting him for some time now.
"In my humble opinion," he ended, "a properly implemented and meaningfully used EMR not only saves money, but most importantly saves lives."
Putting patient safety on hold for the time being, other LinkedIn commenters had plenty to say about the rising costs. Zach Hodges, CPHIT, for example, shared a personal anecdote between him and his grandfather. The story ultimately is about change, and how he equated the story to EHR integration.
His grandfather had been plowing a field in the middle of summer, proud because it was not only the first plow he had ever bought, but because he had the newest model at the time. Unfortunately, a little later on, another farmer had an even more contemporary piece of plowing equipment next door. On impulse Hodge's grandfather bought the newer plow on the inclination that he "had to have it."
He never regretted spending two months worth of pay on it, though.
Fifty years later, Grandpa made another purchase: a $100,000 John Deer tractor. The toy had a built in air-conditioner, a GPS and multi-disc CD changer.
"My Grandpa told me, 'change is going to come, whether you like it or not,'" Hodges explained. "You don't have to always stay ahead of it, but certainly don't want to fall behind it."
Hodges added that he relates this lesson to the current state of EHR adoption in the US.
"Just as my grandfather came to realize the benefits of adopting new technology in farming, I too believe that the current national effort to promote and adopt technology in healthcare will lead to advancements that we cannot even begin to imagine at this time," Hodges continued in his comment. "We have to start somewhere."
Still... where is somewhere? By the time we start, we have to jump other more hurdles. Like Grandpa claimed, change will always come. The key then, is to stay ahead of the curve, implement where necessary and more importantly, don't forget to balance your checkbook.