March 26, 2009

Less Than 2 Percent Of Hospitals Use Electronic Health Records

A U.S. survey showed on Wednesday that fewer than 2 percent of hospitals have completely switched to electronic health records, the Associated Press reported.

Basic electronic systems where at least one department converted to digital could only be found in another 8 to 11 percent of hospitals surveyed.

Dr. David Blumenthal, head of the Institute for Health Policy at Massachusetts General Hospital, noted that the U.S. was in a very early stage in adoption of electronic records compared to other countries.

Last week, Blumenthal was chosen to lead President Barack Obama's $19 billion push to increase the use of information technology in healthcare and to help modernize medical-record keeping systems.

Blumenthal was also among the authors of the new survey published in Thursday's New England Journal of Medicine which had previously found only 17 percent of American doctors have traded their paper patient charts for digital ones.

Despite evidence suggesting electronic health records can improve efficiency and help reduce deaths and injuries caused by medical errors, many hospitals and doctors have been slow to make the leap to paperless.

Earlier this year, President Obama signed an economic stimulus bill that contained $19 billion for computerized medical records, including $17 billion for incentives and penalties to encourage doctors and hospitals to move to electronic systems.

However, the survey pointed out that many are hesitant to switch because of cost, as it would require $20 million for small hospitals and $200 million for large academic centers.

The survey of 2,952 mostly small and medium U.S. hospitals conducted last year showed that about three-quarters of hospitals without a computerized system cited lack of capital as a barrier, 44 percent cited maintenance costs and 36 percent cited doctor resistance.

The study is considered the most comprehensive look to date at the use of digital health records in hospitals.

A comprehensive system was defined as one that collects doctor and nurse notes, orders tests, helps doctors make decisions about care, and is available in every unit of the hospital. They considered a basic system as one that included doctor or nurse notes and was used in at least one care unit, such as radiology.

The results showed that comprehensive systems were noted in only 1.5 percent of hospitals and another 8 to 11 percent had basic systems. There was no difference in adoption rates between private and public hospitals.

Many experts debate whether adopting electronic health records will lead to dramatic cuts in health care spending. But a serious drug error can add more than $8,750 to the hospital bill of a single patient, according to the Institute of Medicine.

"The adoption of more health technology alone is generally not sufficient to produce significant cost savings," the Congressional Budget Office said last year. And a third of hospitals surveyed said they were unsure whether they would recoup their investment.

The survey underscores the difficulties the Obama administration faces as it tries to bring hospitals into the digital age, according to lead author Dr. Ashish Jha of the Harvard School of Public Health.

Jha said Blumenthal has an "enormously difficult challenge ahead" as health technology coordinator. "It is not going to be one of the easier things he takes on in his career."

Advocates agree that different computer systems must be able to talk with one another in order for digital health records to become more widespread. But many hospitals that have gone electronic have systems that currently cannot share information with another hospital or doctor.

"Our members have been pushing to get various digital record-keeping systems to work together," said Don May, vice president for policy at the American Hospital Association.

Blumenthal said the adoption of electronic health records should be part of an overall transformation of healthcare in the United States, including how doctors and hospitals are paid.

"It would be wrong to see this as a technology that can be adopted solely on its own. It needs to be adopted in an environment that supports it," he said.

The Department of Health and Human Services and the Robert Wood Johnson Foundation funded the research.


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