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Five
Innovations Aid the Push To Electronic Medical Records In
last week's State of the Union address, President Bush turned up the
heat on health-care providers to adopt electronic medical records, which
could trim 20% off the nation's $1.6 trillion health-care bill, reduce
the alarming number of medical mistakes, and improve the quality of the
nation's health care. But
while there are a flurry of efforts under way to wire up the health-care
system, the average patient is still a long way from having an
electronic medical record that can be shared among different doctors and
hospitals. The biggest hurdle is cost: there is about $125 million in
the fiscal 2006 budget for a handful of regional demonstration projects,
yet by some estimates it could cost more than $300 billion over a decade
to create a national system of electronic health records -- about the
same amount that studies show is currently wasted on unnecessary or
ineffective medical treatments. Beyond
the clear benefits of putting all a patient's medical information in one
instantly accessible record, electronic record systems include a number
of high-tech tools that help intercept errors, monitor patients, and
prompt doctors and nurses to provide appropriate care. Room
for Improvement "Very
few patients are now getting all the benefits that electronic health
records have to offer," such as links to electronic databases that
help doctors find up-to-date clinical information to use in treatment
decisions, says Mark Leavitt, medical director of the Healthcare
Information and Management Systems Society, the largest group
representing health-information-technology professionals. Because it is
almost impossible for doctors to remember all the latest treatments and
drugs without help, "Without an electronic health record, things
are just going to get more risky and dangerous," Dr. Leavitt warns. According
to a survey to be released next week at the group's annual meeting in
Dallas, only 18% of hospitals and multihospital groups have a fully
operational electronic medical record -- not a big rise from the 12%
that said they were wired up when surveyed five years earlier. And while
25% to 30% of large group-medical practices now have some form of
electronic medical record, the majority of doctors practice in smaller
groups where less than 10% have made the switch from paper, beyond using
computers for billing and administrative work, according to the group. Fortunately,
about two-thirds of health-care providers surveyed by HIMSS say they
plan to implement electronic medical-record systems in the next two
years. And through various incentives, Medicare and private health plans
are making it more attractive for doctors and hospitals to invest in new
systems. In addition to the electronic medical record kept by doctors
and hospitals to document, monitor and manage a patient's care, there is
also a big push for a "personal health record" that patients
can control, share with providers and even add to themselves. That would
help patients monitor their own care -- especially for chronic
conditions like diabetes -- communicate online with doctors, and reduce
unnecessary office visits and frustrating waits for appointments,
refills and test results. Though the tech-speak can be confusing for
consumers, here are the top five ideas and innovations connected to the
push for electronic medical records that could change health care. Top
Five Innovations Computerized
Physician Order Entry:
Though fewer than 2% of hospitals now have the most-advanced versions,
there is pressure to adopt systems that require all orders and
prescriptions to be entered into a computer. Software linked to an
electronic medical record automatically checks medication orders for
drug interaction, allergies or dosage problems, and sends reminders
about proper treatments, alerts doctors to problems, and stops orders
that might cause harm. Clinical
decision support systems:
Software or Web-based programs can offer disease-management guidelines
as well as evidence-based recommended treatment plans. Doctors can
review the plans online with the patient and tailor the recommended care
plan on the basis of their own professional judgment. Electronic
prescribing systems:
A range of devices, including wireless hand-held personal digital
assistants, can send prescriptions directly to pharmacies, look up drug
information and medical history, and let doctors know if patients have
filled prescriptions. These are being used by about 12% to 18% of
doctors at present. Patient
tracking and verification systems:
Hand-held PDAs are also being used to electronically record information
during checkups and treatment, and scan bar codes to make sure the right
medication is being given in the right dose to the right patient. Some
hospitals such as Jacobi Hospital in the Bronx, N.Y., are starting to
work with radio-frequency identification tags that can track a patient
or medical equipment around a hospital, and avoid patient mix-ups in
treatment and blood transfusions. National
Health Information Infrastructure:
Technology companies are working with government and nonprofit groups on
a single data standard that will let competing medical record-keeping
products "talk" to each other, and link a patchwork of
incompatible systems -- much as the banking industry did years ago. The
aim is to create a "network of networks" that will allow
doctors, hospitals, labs, pharmacies and insurers to securely exchange
information about patients, using "record locator services"
that identify patients who have agreed to take part. The network will
also be used to track public-health threats such as disease outbreaks
and bioterrorism. |