GAO report: EHRs can improve patient care

The U.S. Government Accountability Office (GAO) released its report on integrated delivery systems (IDSs) in healthcare. The report found that electronic health record systems (EHRs) are able to improve patient care among such IDSs.

Via GAO:

Some IDSs said that using EHRs supports their patient care strategies such as care coordination, disease management, and use of care protocols by increasing the availability of individual patient and patient population data and by improving communication among providers.

All 15 IDSs which took part in this study have implemented EHR systems. Mayo Clinic, one of the participants, reported that "the EHR helps avoid overutilization and duplication of services."  Several other IDSs reported significant savings because of EHR use, including Marshfield Clinic in Wisconsin, which reported that its e-prescribing feature reduced "errors related to illegible handwriting and unintentional drug interactions." In addition, Marshfield's EHR requires physicians to consider appropriate "preferred alternatives" for prescription drugs, saving payers and patients $2.5 million in 1 year.

You can find the full report here.

"Health Care Delivery: Features of Integrated Systems Support Patient Care Strategies and Access to Care, but Systems Face Challenges," U.S. Government Accountability Office, GAO-11-49 November 16, 2010.

 

DEA to allow e-prescribing of controlled substances

On March 24, 2010, the U.S. Drug Enforcement Administration (DEA) released its interim final rule allowing electronic prescriptions of controlled substances.  According to the DEA, e-prescribing of controlled substances will help reduce paperwork, prescription fraud and errors.  Patients are also quite likely to be pleased by this more convenient and accurate way of filling their prescriptions.

According to Healthcare IT News, "ONC, CMS, AHRQ and other HHS staff have worked closely with the [DEA] to develop the policies in the Interim Final Rule."

The Interim Final Rule is classified as a "major rule" and is therefore subject to Congressional review.  The Rule will be published in the Federal Register on March 31, 2010, but you can preview the unofficial version here.

You can also download the unofficial version of the Rule by clicking here.

"E-Rx of controlled substances Interim Final Rule available," Healthcare IT News (March 25, 2010).

 

 

In the news: Blumenthal on "meaningful use," new health information management jobs, etc.

Dr. David Blumenthal, the National Coordinator for Health IT, gave an update on the Obama Administration's efforts to define "meaningful use" and to further adoption of EHRs nationwide.  Blumenthal did not reveal any new details regarding the upcoming regulations on meaningful use, reminding his audience of the upcoming "notice of proposed rulemaking in late 2009 with a public comment period in early 2010."

Meanwhile, according to Government HealthIT, the next meeting of the HIT Policy Committee, which will meet on October 27 and 28, will focus on how to map meaningful use objectives to medical specialties as well as small practices and hospitals.

Speaking at the 81st annual American Health Information Management Association convention in Grapevine, Texas, Dr. Blumenthal stated that he expects 50,000 health information management (HIM) jobs to be created as the U.S. moves from the paper-based to the digital system of healthcare.  AHIMA's CEO, Linda Kloss, noted that the interest in HIM careers has "exploded" during the last year.

Much more news after the jump.
  

 

  • American Medical News reported on the staffing changes for healthcare organizations necessitated by the nationwide switch to electronic health records. According to the article:

There are some assumptions about staff changes that are easy to make, experts say. Any job that was strictly paper-based prior to implementation, for example, will need to be overhauled or eliminated.

Other changes are not so easy to predict, and could depend on how willing your employees are to adapt and learn new skills.

  • According to Crain's Detroit Business, urban hospitals lag behind rural hospitals and physicians' practices in joining health information exchanges (HIE's) because such HIE's pose a combination of monetary, strategic, and technological challenges.
     
  • Washington Post reported on a pilot project in Ohio aimed at streamlining the cost of healthcare administration.  The state's eight major health insurers - representing 91% of the patients - have signed on to participate in this initiative.  The Post described the program as:

a single Web portal [that the participants] believe will reduce duplication, miscommunication, and confusion between doctors and insurance companies. That will mean quicker office and hospital service, more time for patient care, and, ultimately, cost savings, participants said.

  • Healthcare IT News reported that -- according to e-prescribing company Surescripts -- "the number of physicians using electronic prescribing will have more than doubled in 2009 and that "more than 140,000 – 23 percent of all office-based physicians, nurse practitioners and physician assistants in the United States – are e-prescribing today."
     
  • USA Today reported on the various hardships and setbacks to widespread implementation of EHRs.  The article ended on a somewhat hopeful note, with a great quote by Stephanie Reel, the CIO of Johns Hopkins University:

We've been saying that we're five years away from electronic medical records for the past 40 years ... Now maybe we really are only five years away.

"Meaningful" Progress Toward Electronic Health Information Exchange, David Blumenthal, MD (October 1, 2009).

"Specialists, primary care providers differ in meaningful use," Government HealthIT (October 6, 2009).

"Health IT effort to create thousands of new jobs, says Blumenthal," Healthcare IT News (October 6, 2009).

"How electronic medical records affect staffing," Amednews.com (October 5, 2009).

"Slow with the flow: Hospitals lag in joining health info exchanges," Crain's Detroit Business (October 4, 2009).

"Paperwork angst drives Ohio doctor, insurer effort," The Washington Post (October 5, 2009).

"More than 140,000 physicians on growing list of e-prescribers," Healthcare IT News (October 5, 2009).

"High-tech 'scribes' help transfer medical records into electronic form, " USA Today (October 7, 2009).
 


 

 

In the news

  • Kaiser Permanente and IBM inked a $500 million, seven-year IT services deal.  IBM will manage Kaiser's data center operations, storage and software, but IBM will not have access to patients' medical records.  AP, San Francisco Chronicle (March 17, 2009).
  • A new study expects that as much as three-quarters of prescribers will use e-prescribing by 2014 because of the incentives for adoption of e-prescribing technology included in the HITECH Act (though only about 15% of current prescribers use e-prescribing).  This could result in a massive $22 billion reduction in drug and medical costs.  Government Health IT (March 17, 2009).
  • Wal-Mart is bringing its "high-volume, low-cost" approach to the medical records industry.  Wal-Mart's Sam's Club division will produce a package that will include hardware from Dell, software from eClinicalWorks, as well as installation, maintenance and training services.  According to the New York Times (March 11, 2009), the "Sam’s Club offering, to be made available this spring, will be under $25,000 for the first physician in a practice, and about $10,000 for each additional doctor. After the installation and training, continuing annual costs for maintenance and support will be $4,000 to $6,500 a year, the company estimates." This development has huge implications for the EHR market, and may actually aid the widespread adoption of EHR technology.   Healthcare IT News (March 11, 2009) also covered this story.

More news after the jump.

  • Health Information Security and Privacy Collaboration (HISPC) is working on an engine to help healthcare providers navigate through the complex labyrinth of interstate transfers of health information.  Government Health IT (March 5, 2009).
  • President & CEO of HIMSS Analytics, Dave Garetz, predicts a huge rush in 2009 to adopt HIT in order to qualify for government incentives as meaningful EHR users.  There will likely be a significant shortage of competent HIT personnel and "change management experts" to help in this gigantic transition effort, which further underscores this Blog's urgent plea to begin planning for EHR adoption now.  Healthcare IT News (March 4, 2009).
  • Not everything is coming up roses:  Scott Haig of Time has a thoughtful article outlining some of the major challenges for nationwide adoption of EHR technology.  Time (March 5, 2009).
  • Universities are (and have been for years) the leading sector for publicized data breaches.  A new report examines the reasons.  ComputerWorld (March 9, 2009).  (The author of the article, Jay Cline, was only able 20 chief privacy officers at major U.S. universities, which is a clear sign that the academia - as institutions subject to numerous data privacy laws, including HIPAA, GLBA and FERPA - should be much more proactive and serious about data privacy protection.)