Why haven't EHRs made us healthier?

"We imagined a future that looked a lot like what we were being promised"
By Glen Tullman
01:20 PM

But does anyone really believe we should go back to paper? In fact, more than ever, people understand that making digital records work is critical to fixing health care. The annual Healthcare Information and Management Systems Society (HIMSS) conference, held this week in New Orleans, is expecting 35,000 people and 1,000 vendors to focus on that task.

The President’s Council of Advisors on Science and Technology concluded in a recent report that “the impact of IT on health care over the past decade has so far been modest.” The key words: so far. Investors and the industry would be wise not to underestimate what’s coming. It is nothing short of an explosion in innovation and creativity, facilitated by open systems and connectivity.

What the Council found is that the technology can fix itself. As these systems, which doctors and hospitals have spent billions to install, begin to talk to each other and to patients, everything will change. Right now, as the report says: “The ability to integrate electronic health information about a patient and exchange it among clinical providers remains the exception rather than the rule.” This is exactly what needs to change.

Remember when the RAND Corporation predicted $80 billion a year in annual savings and 285 million fewer sick days? I’m here to tell you that will happen, and sooner than you think. Intelligent policies out of Washington that force vendors to connect and interoperate (just like our bank ATMs and phones do) and hospitals and physician buyers demanding the same will fuel this revolution. Most important, patients will not be patient anymore. They will begin to demand access to their own information and their own records.

So what does our community need to commit to accomplishing?

First, we have to finish the job of getting physicians on board. The CDC reported in December that 73 percent of physicians now use electronic health records, up from about a third two years ago. So we have made great progress, but still have too many physicians using paper.

Then we have to get these records connected to each other. The industry, through HIMSS, and the government, through the Office of the National Coordinator, are pushing for interoperability. With the exception of one or two, most vendors are falling in line. Medicare, insurers and consumers will have to exert pressure, since individual players may benefit from locking down their own data. But once the network is open, we’ll see the same exciting progress that we’ve witnessed in our lives outside of health care.

Meanwhile, the systems that have already been installed need to work better. They’re still not easy to use, and this is coming from someone who spent 15 years developing and selling them. The industry can do better, and the industry will, especially with the development of new iPad and other mobile apps. And we have to fundamentally change the electronic health records. Today, they tend to be “information retrieval” tools. “What you see is what you just wrote,” is not the kind of value we should be adding. The computer does not help the doctor practice better … yet. The patient does not learn much from the data … yet.

But once records are open, connected, and more user-friendly, we can start to add intelligence to the network that will help doctors, nurses, care coordinators and patients all do a better job improving health, not health care.

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