Managing the enormous volume of data that medical practices keep for their patients requires digitization. In order for doctors to collaboratively deliver optimal healthcare for each patient, an interoperable system of electronic health records (EHR) is necessary. Such a system enables instant data exchange between medical providers and insurers.
The stakeholders within these organizations have legitimate concerns about implementing EHR. These concerns have slowed the progress of widespread use — and more importantly — of the interoperability of these systems.
After clearing several hurdles, the healthcare industry is well on its way to the transformation it needs. Milestone policies like HIPAA, the Affordable Care Act and the HITECH Act have established standards and incentives for digitizing, protecting and sharing records. The industry is driving closer to using EHR as its foundation for collectively managing patient health, but the road to this point has been rough.
Why EHR Is Critical to Medical Practice Management
On a broader level, EHR technologies can cut overall healthcare costs, speed insurance claims processing, and even recognize and contain epidemics. At the patient level, storing and sharing digitized health records enables practices to provide the right care based on medical histories.
America’s healthcare costs are a staggering $2.7 trillion annually — nearly 18 percent of gross domestic product. In spite of the expense, the quality of care is declining as doctors spend more time and resources on paperwork and insurance. To survive, they have been raising volumes of visits rather than focusing on quality of care.
As part of the solution, EHR reduces the time it takes for doctors to get the information they need about patients. They can search records rapidly and retrieve specific information instantly from specialists. Providers can see recent test and lab results and avoid scheduling redundant appointments. Doctors can also dispatch prescriptions quickly on automated systems that keep track of dosage information and refills.
While doctors talk with patients and enter information, the systems provide digital prompts, like warnings not to prescribe certain medications or suggestions for appropriate treatments. The systems constantly synthesize patient data with outcome data to proactively inform doctors about patient needs and provide treatment reminders. There is too much information in today’s complex healthcare industry for doctors to remember, so an EHR system can help ensure they stay current.
Interoperability, Cybersecurity and Other Hurdles for EHR
While the entire U.S. healthcare system is now digitized, most EHR systems work independently but fail to interoperate. That is, they archive medical data, but the proprietary systems cannot exchange this data with one another. This is a serious problem.
It is not a technology problem; it is an economic problem. Current anti-kickback laws eliminate the potential financial gain for physicians and hospitals to provide data to other practices that need it. These laws still need to be repealed to enable widespread interoperability.
An open exchange of data also makes it easier for patients to switch medical providers. In states where patients can easily obtain their medical records, the percentages who switch their PCPs and specialists increase by 11 and 13 percent, respectively. Clearly, providers need an incentive to counter this disincentive.
EHR vendors are unmotivated to remove the barriers to interoperability because there is no profit incentive. In fact, many go so far as to intentionally create obstacles to limit information exchange, otherwise known as data blocking. The Office of the National Coordinator for Health IT could monitor EHRs in medical practices to prevent this. However, this would be extremely costly, as well as risky to patients’ privacy.
Another equally serious barrier to interoperability is the privacy of patients’ records and vulnerability to cybersecurity threats. Since 2009, the data of more than 155 million Americans has been exposed through 1,500 breach incidents. Weak cybersecurity practices have made EHR systems vulnerable to attacks in which hackers lock down systems and hold them for ransom. The solution may be financial incentives and marketplaces for providers to invest in adequate cybersecurity.
Legally, medical practices are also concerned about increased exposure to lawsuits with the open exchange of patient data through EHR because plaintiff attorneys can use the computerized data against them in malpractice suits. This hurdle remains to be addressed.
HITECH Act Stimulated EHR Adoption
In February 2009, President Obama signed the Health Information Technology for Economic and Clinical Health Act, better known as the HITECH Act, to provide $27 billion in financial incentives for electronic health records use.
This was vital in overcoming the costs to medical practices, which had to pay for systems that delivered no direct benefit to their bottom lines. Through the HITECH Act, outpatient physicians could receive up to $44,000 from Medicare or $63,000 from Medicaid over five years by investing in EHR. Similarly, hospitals could be reimbursed for millions of dollars. The law also called for financial penalties beginning in 2015 for practices that did not invest in these systems.
These incentives have been successful; every medical provider is now using an EHR system according to the Brookings Institution. One of the most important next steps is educating the current and future workforce in the use of these complex systems.
The Industry Needs MBAs in Healthcare Information Systems
Specialized programs like the Southeastern Oklahoma State University Master of Business Administration with an emphasis in Healthcare Information Systems online have been developed to meet the needs of the healthcare industry. This program covers health information systems, electronic health records, EHR laws and the politics on industry changes. As education and technology continue to evolve, America is poised to overcome the greatest challenges to delivering world-class healthcare.
Learn more about the SOSU online MBA with an emphasis in healthcare information systems program.
Bloomberg: Why Don’t More Hospitals Use Electronic Health Records?
Health Affairs/Robert Wood Johnson Foundation: Health Policy Briefs — Interoperability
Health IT Dashboard: Adoption of EHR Systems Among U.S. Non-Federal Acute Care Hospitals: 2008-2015
Brookings Institute: The Future of Health Information Technology in a Trump Presidency
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