Health care is a team effort. Shared information supports that effort. When all team members can communicate with each other effectively and efficiently, everyone benefits—patients, their families, and providers. The Nation's health and economy benefit as well. Adopting electronic health records (EHRs) requires investment of time and money, but the benefits often outweigh the costs, and financial incentives are available to help providers make the transition.
Better Information Means Better Health Care
The main goal of health IT is to improve the quality of patient care. The promise of fully realized EHRs is having a single record that includes all of a patient's health information: a record that is up to date, complete, and accurate. That makes all providers "smarter" and in a better position to work with their patients to make good decisions.
Providers who use EHRs report tangible improvements in their ability to make better decisions with more comprehensive information. Adopting EHRs can give health care providers:
- Accurate and complete information about a patient's health. This enables providers to give the best possible care, whether during a routine office visit or in a medical emergency.
- The ability to better coordinate the care they give. This is especially important if a patient has a serious or chronic medical condition, such as diabetes.
- A way to share information with patients and their family caregivers. This means patients and their families can more fully take part in decisions about their health care.
Better Information Means Safer Health Care
Health IT can play an important role in increasing patient safety. Specifically, adopting EHRs can enhance patient safety through:
- Comprehensiveness: EHRs can give providers the information they need to evaluate a patient's current condition in the context of the patient's health history and other treatments.
- Speed: In a crisis, EHRs provide instant access to information about a patient's medical history, allergies, and medications. This can enable providers to make decisions sooner, instead of waiting for information from test results.
EHRs can also flag potentially dangerous drug interactions (to help prescribing doctors explore alternatives before a problem occurs), verify medications and dosages (to ensure that pharmacists dispense the right drug), and reduce the need for potentially risky tests and procedures.
Electronic Prescribing (e-Prescribing)
Paper prescriptions can get lost or misread. With electronic prescribing (e-prescribing), doctors communicate directly with the pharmacy. An e-prescribing system can save lives (by reducing medication errors and checking for drug interactions), lower costs, and improve care. It is more convenient, cheaper for doctors and pharmacies, and safer for patients. In short, e-prescribing is an important, high-visibility component of progress in health information exchange.
Embracing the Transition to EHRs: Some Facts and Figures
Health IT is where the profession is going.
- 90% of medical students consider it important or very important to have an EHR where they choose to practice ("4th Annual Future Physicians of America." (2009). Epocrates. Retrieved September 29, 2010, from www.epocrates.com)
- 24.9% of office-based physicians in the U.S. had adopted at least a "basic" electronic health record in 2010 (SK&A data)
- 41% of office-based physicians in the U.S. planned to adopt an electronic health record and apply for meaningful use incentives in 2010 (SK&A data) 15.2% of acute care non-federal hospitals had adopted at least a "basic" electronic health record in 2010 (American Hospital Association's Survey of IT Adoption)
- 81% of acute care non-federal hospitals planned to adopt an electronic health record and apply for meaningful use incentives in 2010 (American Hospital Association's Survey of IT Adoption)
What Does the Evidence Show?
Evidence of benefits from EHRs, e-prescribing, and other components of health information exchange is mounting.
- Researchers at the Center for IT Leadership (2010) studied the U.S. Department of Veterans Affairs, an early adopter of health IT and exchange, and estimated that savings from preventing adverse drug events alone totaled $4.64 billion.
- Frisse and Holmes (2007) found that health information exchange can save cities millions both by lowering administrative costs and by improving preventative health care. For example, the researchers estimate that the Memphis region could save more than $8 million a year through a regional health information exchange.
- In Indianapolis, Finnell and Overhage (2010) found that a majority of emergency medical professionals said they benefited from access to pre-existing health information—medication lists, allergies, medical histories—through electronic exchange. Medics said the information was especially useful for patients with frequent emergencies and those who were unconscious, uncooperative, or otherwise unable to provide medics with needed information.
- Shapiro et. al. (2011) examined health information exchange projects in 48 States. Although the projects faced some financial and technical hurdles, they showed enormous potential for improving public health reporting and investigation, emergency response, and communication between public health officials and clinicians.
- Persellet. al (2011) found that EHRs can use information on patients' medical histories to improve quality significantly by reminding providers of the best methods of care for specific patients.
What is Meaningful Use?
As you get involved with electronic health records, one of the things you'll hear about is the concept of "meaningful use"—part of the standards and criteria developed in the health IT field to encourage a smooth, productive transition to EHRs.
"Meaningful use" refers to the use of certified EHR technologies by health care providers in ways that measurably improve health care quality and efficiency. The ultimate goal is to bring about health care that is:
Health Information Privacy and Security
The need for privacy and security is at the forefront of the health IT movement. Like paper medical records, electronic records must always be private and secure. Health IT can help protect patient information through:
- Access controls to make sure only those who are authorized can access health information
- Audit functions that track who has accessed what pieces of health information
- Internet-based portals that allow patients to access their own health records, see who else has viewed their records, and check the accuracy of the records
Electronic Health Record Incentives
As America moves toward broad adoption of health IT, Medicare and Medicaid EHR incentive programs can help providers with the transition.
Incentive payments include:
- Up to $44,000 for eligible professionals in the Medicare EHR Incentive Program
- Up to $63,000 for eligible professionals in the Medicaid EHR Incentive Program
- A base payment of $2 million for eligible hospitals and critical access hospitals, depending on certain criteria
Electronic Health Records (EHRs) can improve health care quality. EHRs can also make health care more convenient for providers and patients.
A national survey of doctors offers important evidence (DesRoches, C., et al, "Electronic Health Records in Ambulatory Care - A National Survey of Physicians", New England Journal of Medicine, 2008;359:50-60.):
- Providers report that EHRs have a positive influence on their practices.
- More than 90% of all doctors with EHRs are satisfied with their systems.
- Better technology makes it easier to attract and retain staff.
- Patients equate new technology with quality. When they see their doctors using new technologies, they start to approach their own care-related decisions differently.
- Patient communication is greatly improved when new technology is used to its fullest.
Snapshot of Improved Health Care Quality and Convenience for Providers
- Quick access to patient records from inpatient and remote locations for more coordinated, efficient care
- Enhanced decision support, clinical alerts, reminders, and medical information
- Performance-improving tools, real-time quality reporting
- Legible, complete documentation that facilitates accurate coding and billing
- Interfaces with labs, registries, and other EHRs
- Safer, more reliable prescribing
Snapshot of Improved Health Care Quality and Convenience for Patients
- Reduced need to fill out the same forms at each office visit
- Reliable point-of-care information and reminders notifying providers of important health interventions
- Convenience of e-prescriptions electronically sent to pharmacy
- Patient portals with online interaction for providers
- Electronic referrals allowing easier access to follow-up care with specialists
How EHRs Foster Patient Participation
Electronic health records (EHRs) can help providers:
- Ensure high-quality care. With EHRs, providers can give patients full and accurate information about all of their medical evaluations. Providers can also offer follow-up information after an office visit or a hospital stay, such as self-care instructions, reminders for other follow-up care, and links to web resources.
- Create an avenue for communication with their patients. With EHRs, providers can manage appointment schedules electronically and exchange e-mail with their patients. Quick and easy communication between patients and providers may help providers identify symptoms earlier. And it can position providers to be more proactive by reaching out to patients.
The Patient's Perspective
Information technology is at the heart of modern life. It touches different people in different ways. Some are comfortable with new technologies; others may be intimidated, at least at first. EHRs, PHRs, and other health IT developments tend to make many patients more active participants in their own health care. As providers adopt new technologies such as EHRs, it's important to keep the patient's perspective in mind.