Monday, January 7, 2008

Electronic Medical Records: The $77 Billion Solution

Reform of the American health care system is a huge part of the current political discourse. A major aspect of that reform as proposed by George Halvorson in his book Health Care Reform Now! is widespread adoption of Electronic Medical Records (EMR's or EHR's).

EMRs are making news on both the east coast and west coast this week. On the east coast Senator Hillary Clinton pressed for EMRs in response to a question from the crowd in a New Hampshire appearance.

C|net news blogger Anne Broache provides a sound bite from Sen. Clinton's comments:

"We go online to buy things from Mongolia, we go online to do our banking, but we can't go online in a secure, encrypted, confidential way to get access to our medical records," she lamented.
Diana Manos, Senior Editor of Healthcare IT News also covers the story:
The adoption of EHRs [electronic health records] is not new to Clinton, who has included them as a kingpin to her presidential healthcare platform from the start. Gearing up for New Hampshire's primary next Tuesday, Clinton told voters that moving to electronic records from paper could save an estimated $77 billion in healthcare costs.

Last May at George Washington University, Clinton said that moving healthcare from paper to electronic records is among several key ways the country could cut runaway healthcare spending by one third.
The other side of the U.S. brings more news about EMRs. Reuters offers a press release about Cisco Systems joining the effort to create the country's largest health information exchange service:
"Cisco recognized early on the importance of transforming the health care
system through electronic health records and information sharing," said Nick
Augustinos, Cisco Internet Business Solutions Group Director. "Through
collaboration with CalRHIO and other technology leaders, we believe California
will lead the nation in creating a statewide health information exchange
system that not only supports clinicians, but also helps consumers make better
health care choices."
Cisco partners with HP, Perot Systems Corporation, and Medicity, Inc. as partners in this effort. The final objective is to enable EMRs to be shared in a confidential manner among health care providers across the state of California as well as through the National Health Information Network (which is currently under development).

Before EMRs grabbed the attention of the U.S. Presidential contenders, healthcare delivery systems were already moving toward shared electronic records. Prompted by individual states or by financial self-interest, health care providers and employers have decided not to wait for federal legislation. Now that the politicians are climbing on board, it's hard to imagine a future that does not include easy access to medical records over the Internet.

SOURCE: "Clinton presses for electronic medical records" 01/04/08
SOURCE: "Clinton: Time to digitize all Americans' medical records" 01/04/08
SOURCE: "Cisco Joins CalRHIO Effort to Build Country's Largest Statewide Health Information..." 01/07/08
photo courtesy of Kevin Zollman, used under this Creative Commons license


  1. I have received a partial, printed hardcopy of my EMR from my PCP.

    I am insured through the same managed care organization I work for, and the hospital system of which it is a part is a leader in the area of EMR use.

    Even so, getting this information wasn't easy and the format that I have received it in isn't particularly useful. To the credit of my PCP, he did offer to try to get a more complete, albeit still paper-based, set of records for me, but warned that there would probably "be a fee."

    While I am a big believer in EMRs as part of the solution to America's healthcare problem, I don't think their full potential will ever be realized as long as providers continue to see them as something other than the patients'.

    Healthcare has traditionally bucked the established pay-for-services model that the very idea that EMRs and their contents belong to the patients, that patients have a right to them, and that providers have a responsibility to provide them as a matter of course is going to severely impede their adoption in the short-term, in my opinion.

  2. Jeff,

    Great comment. I, too, recall struggling with a health care provider recently to even get a look at my own file, much less take it home or access it online. That sort of proprietary stance on the part of health care providers has got to go.

    Access to medical records is a thorny issue and we'll continue to report on all sides of it. What piece of the EMR should pharmaceutical companies get to see? Insurers? Underage patients? Pharmacists?

    While all these people might wish to access full EMRs, the amount of information they are allowed to see should be regulated, in my opinion, by the individual rather than by the state. Interesting subject and thanks for sharing.

    Health Care Reform Now! blog staff

  3. I am a pediatrician and have been interested in computers in medicine since residency in the early-80's (when you could buy a Corvus 5meg hard drive for a mere $3,000). EMR's are NOT ready for prime time until you can transfer electronically between systems. Currently each EMR is an island. To go from one to another you have to go through paper. Patients trade locations and doctors frequently - so a medical record could easily become composed of several "paper" dumps. EMR vendors put all of their effort into making their EMR better - and NO effort into making it easier to leave their product. Each vendor wants a captive audience. None wants their doctor to leave. I don't trust the government to make an EMR efficient or it would have already done so in the military. The $77 billion dollar in savings must not include the cost of installation. I know of practices (pediatric) who have spent more than $30,000 per doc and still don't like it. At $30k a doc, that would dwarf 77 billion in "savings".
    Until I as a doctor can move my patient records easily between vendors, AND patients can walk out of a practice with an electronic copy of their medical record ready to import into another doctor's system, EMR is not ready for prime time.
    Graham Barden


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