While very few practices have fully implemented electronic health records, a majority of health executives feel they will have a positive financial impact over the long term, according to a new report by Capgemini Health Practice. The survey also found support for the government taking a more active role in coordinating integration efforts.
Capgemini researched the attitudes of health industry executives toward EHRs themselves and toward the governments role in coordinating health IT.
The survey consisted of responses from 84 executives at hospitals, health insurance plans, physician groups, health technology vendors and other health organizations. Seventy percent felt EHRs would, over the long term, have a positive financial impact. Just over half had held internal discussions concerning EHRs. About a third had conducted a financial analysis or examined the business case.
The Capgemini report found that costs (58 percent), physician resistance (46 percent) and lack of technology standards (30 percent) were considered the greatest barriers to adoption. In addition, several respondents thought financial incentives for physicians would be necessary for adoption.
The survey also found that the role of payers like health insurers in promoting EHRs is unclear.
Payers are most keen to promote the e-prescribing aspect of EHRs, said John Quinn, chief technology officer of Capgeminis provider health practice. Thats because “they can effect savings through formulary adherence,” or influencing what brands of drugs are prescribed.
Beyond that, he said, insurers might get involved if there is already an initiative in their region, “but when you get right down to it, it may be a while before someone puts a pen to a checkbook,” he said.
Most systems fall short of an EHR as envisioned by the federal government, which would be shared by different providers, follow the patient and support several applications, like computerized order entry, follow-up prompts and clinical specialty needs. In addition, patients would be able to access their records and request what information would be confidential.
However, said Quinn, the report challenged the governments stance that a national patient identifier should not be used, concluding that it should at least be considered.
“Its not so much that we need an identifier; we need a way to be sure that we know that the information is about who were dealing with and that its all of the information,” he said. The option of a national patient identifier should stay on the table until some other identification system could demonstrate that it was just as accurate.
The survey recommended that consistent definitions for EHRs be established and that the industry should be informed of the specific functions necessary to meet the governments vision. That way, the government can make sure that any physicians stepping up to claim rewards for using an EHR are actually using them.
EHRs still need to expand their reach into more clinical departments such as surgery management, radiology, and ambulatory and emergency care. In particular, the systems should expand to cover other hospitals in an area as well as affiliated physician offices and local health departments.
Specific suggestions in the report were as follows:
- develop uniform technology standards for interoperability, data input and format, and data exchange;
- provide financial incentives and support by providing tax credits, grants and other subsidies and by allowing health systems to give away technology to physicians;
- mandate compliance and require implementation within a certain time frame;
- educate physicians and the public about the best ways to implement EHRs and the benefits of doing so; and
- establish a formal government role and infrastructure and provide oversight.
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