The U.S. Health and Human Services Department yesterday issued a more flexible 5-year plan to impel doctors and hospitals toward implementing electronic health records.
That’s the push.
The pull is that converting from paper to electronic record-keeping is expected to improve the delivery of medical care, result in greater patient safety, and reduce provider costs.
Sounds good to me.
But how are health care organizations supposed to manage their transition? Converting from hard copy to soft is hard enough without the pressures of federal mandates and concerns over patient privacy and systems security dangling overhead. And for all the politico- and vendor-touted examples of organizations already moving down the EHR path, the fact is, says Health and Human Services Secretary Kathleen Sebelius, “Only 20% of doctors and 10% of hospitals use even basic electronic health records.”
This week’s announcement relaxed the definition of “meaningful use” as it applies to installing EHR solutions and thereby qualifying for federal funding. For instance, the government’s original proposal required that 75% of prescriptions written be electronic, whereas the new iteration calls for only 40%.
But because so few providers are EHR-enabled right now, the rule changes in some ways are all but irrelevant, as the issue for them isn’t 40% or 70%, but any percent at all.
There’s little doubt that EHR technology will do much to transform the way health care is delivered in this country, and the unleashing next year of federal monies to help ease the switchover certainly will help the process along. But fundamental practical questions still remain to be asked, never mind answered, and one only hopes that providers become significantly engaged sooner rather than later, for the work required to meet the 2015 compliance deadline is rather more than meets the eye.
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I am concerned about the long-term preservation of digital health records. Those records should remain viable for a baby’s life expectancy (and even longer for longitudinal studies or to inform heirs’ health choices).
Unfortunately, 20 years is really pushing the limits of obsolescence for removable media, operating systems, application software and output drivers, to say nothing of overcoming encryption and lost passwords.
And the solution is…….?