Little Return on $26B Investment in Health IT by Feds

Despite more than $24 billion in incentive payments to hospitals and eligible professionals who "meaningfully use" electronic health records and another $2 billion spent on interoperability standards and EHR certification, there is very little electronic information sharing among providers.

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Comments (5)
If anyone knows of an academic study which demonstrates that the electronic sharing of medical information results in better care (or less costly care) than our current paper/fax system, please send me the link/article.

Thank you.

Hayward Zwerling, M.D., FACP, FACE
HZMD@me.com
President, ComChart Medical Software, www.ComChart.com
The Lowell Diabetes & Endocrine Center, www.DiabetesEndocrine.com
Posted by Hayward Z | Wednesday, August 13 2014 at 8:49AM ET
From my standpoint as a clinical analyst...we are still trying to get our system working optimally for inputing the data and reengineering work flows...sharing of information electronically is on the backburner until we get our patient care ducks in a row. Not to mention, HIE's are confusing and very unprepared.
Posted by Rhonda S | Wednesday, August 13 2014 at 11:57AM ET
It should be nice if insiders & analysts could quantify (estimate) the movement of data traffic from phone, fax, mail and siloed information-sharing networks to the emerging so readers could see the lack of progress measured in data units (e.g., bytes or bits but not messages or images because they are not real data units) on a graph with germane events like medical treatment facilities' Health IT go-live events. I think one could derive the theoretical data volume and exchange from billing records and the sequence of encounters between providers who by good practice, need medical data that previous providers acquired and were reimbursed. Besides asking for the phone, fax and postage account activity of every provider to validate the transfer of data exchange on HIEs, what else is there to verify the desired outcome?
Posted by William G | Wednesday, August 13 2014 at 2:39PM ET
As a data warehouse designer for healthcare data (insurance), I can tell you that there are few, if any, quantitative studies on how much money is saved by making systems communicate with each other - because the entire industry is still in its infancy. While you can eliminate paper from one particular system, you are still prone to the same mistakes in electronic form that were made with paper and pencil (can't read doctor's handwriting, incorrect coding, etc) - so there's no point in trying to get these systems to communicate before you come up with a standard for data quality and format. And right now, that doesn't exist.

As a healthcare consumer, I have enjoyed watching the EPIC (no relationship to them, just what they use at my hospital) system mature, building in referential checks and data dependencies at exam/procedure time, to eliminate the data quality problems at the source. I would be willing to bet there are studies that show how these kind of improvements reduce administrative costs.

I can also give you a direct example of how electronic sharing can reduce costs - when my father was admitted to the hospital for throat cancer, they performed a PET scan to determine the severity of the blockage (was having trouble breathing). When the emergency was over, he was passed off to an oncologists office, who ordered the exact same exam - because they were denied access/couldn't interface between the office and hospital. The funny/sad part is that the scan was done both times in the same facility.

I think the short answer is you have to walk before you can run. You need some level of maturity in the source systems before you can think about getting them to communicate with one another. Having said that, if you get everyone working toward implementing the same set of standards, you can hopefully shorten the time to real sharing (and real cost savings).

CH
Posted by Charles H | Wednesday, August 13 2014 at 7:38PM ET
It is interesting that the last paragraph of the article refers to Stage 2 MU being more "robust". It seems apparent from the anemic numbers coming in on participation for Stage 2 MU, that the entire program is likely to collapse. According to an article in HDM earlier this month, only 1898 physicians had attested for Stage 2 MU. And only 78 hospitals have attested for Stage 2 MU. That means that far less than 1% of the eligible providers and hospitals have even attested! How can a program continue to exist with such abysmal participation? Yes, I'm sure we will see a spike in the numbers this fall and winter, but what will we see? 5%? Maybe 10%? Is that sustainable?
Bill B.
Posted by BILL B | Monday, August 25 2014 at 5:51PM ET
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