A battle royal rages on among various Harvard physicians about the effects of a widespread adoption of EHR technology. In a Wall Street Journal op-ed, two Harvard doctors questioned President Obama's claim that nationwide adoption of EHR technology will save the taxpayers as much as $80 billion annually. Drs. Groopman and Hartzband call on Mr. Obama to "apply real scientific rigor to fix our health-care system rather than rely on elegant exercises in wishful thinking."
However, three other Harvard physicians, including Geek Doctor John Halamka, published a Letter to the Editor in response to the Groopman/Hartzband Op-Ed, claiming that the latter did not present a full or accurate picture of the positive effects of widespread adoption of EHR technology. In part, Drs. Halamka, Bates and Middleton claim that:
The electronic health record represents a transformational change in healthcare, and will enable an array of improvements—although it will not necessarily result if implemented badly. The electronic record is to the paper record as the automobile was to the horse and buggy. No one will want to go back.
Separately, Stephen B. Soumerai, a Harvard Medical School professor (with a University of Alberta co-author, Sumit R. Majumdar) published an Op-Ed in the Washington Post supporting the Groopman/Hartzband claim that EHR technology is not going to produce the promised mass savings because major studies
have found that electronic records with computerized decision support did not result in a single improvement in any measure of quality of care for patients with chronic conditions including heart disease and asthma.
Soumerai and Majumdar sadly concluded that "a $50 billion investment in health information technology won't do much for many Americans."
This did not go unnoticed by Halamka and the EHR enthusiasts, Drs. Bates and Middleton. Their response in another Letter to the Editor (this time, in the Washington Post), systematically deconstructed Soumerai and Majumdar's conclusions, reinforcing the theme articulated by Halamka, Bates and Middleton in the Wall Street Journal: bad implementation can lead to bad results; EHRs are the way of the future, and the focus should be on how to improve quality of care, not whether to implement EHR technology. The Letter to the Editor also cited specific examples of savings produced by successful adoption of EHR technology:
a detailed case study of the cost and quality benefits of EHR at Family Care of Concord, NH found net benefits per clinician per year of $30,324. Another study of hospital-based provider order entry identified net savings of $1.7 million per year from drug dosing guidance, nursing time utilization, and error prevention.
While the fight continues at Harvard, there is some positive news from Wall Street. The Wall Street Journal reports that the HIT funding included in the stimulus appears to boost stock prices of certain HIT vendors, including Quality Systems Inc. (QSII), Athenahealth Inc. (ATHN) and Allscripts-Misys Healthcare Solutions Inc. (MDRX). Thus, it appears the stimulus is working for someone. Let's hope the EHR enthusiasts at Harvard are correct, and that we will all benefit from lower-costs, increased efficiency and higher-quality health care as a result of nationwide EHR adoption.
"Obama's $80 Billion Exaggeration", Wall Street Journal, March 11, 2009.
"Bad Bet on Medical Records", The Washington Post, March 17, 2009.
"Health IT Push Helps Physician Practice Software Stocks", Wall Street Journal, March 23, 2009.
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.