“We’ve not achieved the productivity and quality benefits that are unquestionably there for the taking.”
Who made this stunning remark and what was the speaker referring to?
So said Dr. Arthur L. Kellermann, one of the authors of a reassessment by RAND that was published in this month’s edition of Health Affairs, an academic journal describing the United States health care system’s cost savings by implementing electronic health records (EHR). In 2005 Rand published a study that claimed by implementing EHR the American health care system would save as much as $81 billion per year.
According to federal agency reports, since the report was issued health care spending has increased by $800 billion. The reason for this steep rise can be attributed to many factors including, more people receiving medical services, high cost of medical innovations and of course the aging of Baby Boomers.
The RAND report was paid for by General Electric, Cerner Corporation, Johnso & Johnso, Xerox and Hewlit-Packard as well as other members of the EHR industry. The 2005 report by Rand received plenty of attention. According to Dr. Kellerman who was not involved with the 205 study:
“RAND got a lot of attention and buzz with the original analysis, the industry quickly embraced it.”
In 2005 the Congressional Budget Office reported that it was their finding that the report was “overstating expected benefits.”
Not only is there almost no evidence of cost savings due to EHR, industry officials are worried that costs have increased as the systems have added to costs by capturing all services a patient receives and billing for them.
RAND said that their latest analysis did not attempt to put a number on how much EMR has increased or reduced health care spending, but they do admit that the earlier study was overly optimistic. This acknowledgement is fueling the fire of controversy of about the expense and too rapid implementation of EMR .
WHY DID THE 2005 RAND STUDY MISS THE MARK?
One reason cited by RAND is that the newly installed systems do not allow for information to be shared across platforms. Hospitals and medical providers cannot communicate from system to system. Also, RAND says that despite cash incentives, adaptation of EMR has been slower than expected and also that present electronic record systems are not geared to providing benefits for high volumes of patient care.
Most experts think that available systems are designed to promote more advantageous billing by providers rather than promoting better patient care or cost savings. In fact, federal authorities are beginning an investigation to see if the EMR makes fraudulent billing for services not provided to Medicare patients easier.
The federal government has announced it is drafting new rules that will address a good deal of issues that have come to light with the current systems.
Dr. David J. Brailer, who served under President George W. Bush as the country’s first health information czar feels that most of the problems with EMR can be attributed to the haste with which the Obama administration implemented the program and the billions of dollars it awarded to providers who installed systems as incentive payments. Said Brailer:
“The vast sum of stimulus money flowing into health information technology created a ‘race to adopt’ mentality — buy the systems today to get government handouts, but figure out how to make them work tomorrow.”
Alan E is a freelance writer/editor with a background writing about healthcare issues.
Edited by Jordan Glogau
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