If the federal government’s ambitious new plan to digitize the nation’s medical records comes about, filling out reams of paperwork at the doctor’s office may become a thing of the past.
Thus far, however, those who would benefit most from a break in pushing paper — doctors — have balked at the feds’ road map. Dozens of physician groups oppose the specifics of the plan, even as they’ve expressed support for the expanded use of health information technology (HIT).
The docs have a point. If done improperly, a HIT overhaul could make American health care less effective and more expensive. As they craft the nation’s health IT strategy, policymakers must collaborate with doctors and hospitals to ensure that the new technology actually results in a more efficient, higher-quality health care system.
Electronic medical records have the potential to reduce health care costs, minimize physician error, shorten wait times for patients, and save lives. But such results are hardly guaranteed.
According to a study released earlier this year by Michael Furukawa, Raghu Santanam and Benjamin Shao — three professors at Arizona State University’s W.P. Carey School of Business —- previous efforts to switch to digital medical records have sometimes increased health care costs and decreased quality.
To avoid past mistakes, policymakers should take several principles to heart.
First, HIT initiatives must ensure that doctors will be able to deliver high-quality care — and that patients will continue to have access to it. The current government plan fails on this count.
How so? Last year’s stimulus package encouraged physicians to digitize their health records by making billions of dollars in subsidies available. Unfortunately, doctors were not eligible for the subsidies unless they complied with an array of “meaningful use requirements” so dizzying that virtually no doctors could meet them — including the most tech-savvy health systems in the country.
Kaiser Permanente, for instance, practically invented electronic medical records. But the company’s executives have said that they simply cannot meet the criteria set by the Obama administration for receiving funding.
President Barack Obama has repeatedly praised Intermountain Healthcare in Utah as a model health system. But Intermountain’s chief medical officer recently revealed that his company could not meet 36 of the 48 meaningful use criteria laid out by the government.
Doctors and hospitals will face financial penalties if they do not comply with the government’s dictates by 2015. As a result, health care providers may be forced to make expensive investments in IT systems even as they’re deemed ineligible for the subsidies they were promised. Providers will no doubt pass along the cost of those investments to patients.
Further, 68 percent of doctors believe that complying with meaningful use standards will decrease productivity, according to a recent Medical Group Management Association survey.
Patients could therefore face longer wait times, higher costs, and more — not fewer — medical errors.
Other critics of the government standards have expressed concern that the rules will drive physicians to practice one-size-fits-all medicine — perhaps at the expense of improving a patient’s condition. Health IT could easily be perverted to push doctors to prescribe the cheapest drug for a given malady even if a more expensive one might work better for a particular patient.
Health IT should make it easier — not harder — for doctors to treat their patients.
HIT programs should also leave physicians free to order the tests, treatments, and procedures they see fit. Doctors must resist attempts by government agencies or insurers to use health IT as a covert way of limiting expensive care. Health IT will be counterproductive if it leads to denials of needed care.
Finally, HIT systems must safeguard patient privacy. Electronic medical records will soon allow a doctor in Phoenix to call up the medical history of a visiting New Yorker who needs emergency surgery with the click of a button.
Unfortunately, when personal medical information is easily transferable, it’s also susceptible to theft by hackers and identity thieves. The architects of a nationwide health IT infrastructure must prevent such breaches from happening.
Computerizing the nation’s medical records could save lives, money, and time. But it needs to be done right. Instead of dictating unreasonable — or even unachievable — requirements, the federal government must work with health care providers to ensure that new health IT initiatives enhance medical quality, affordability, and patient privacy.