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The Promise and Peril of Electronic Health Records

The Promise and Peril of Electronic Health Records. Cari Weishaar Final Project 12/8/11. Health care costs are too high…. Source: OECD 2009. …and quality metrics are not better than other countries….

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The Promise and Peril of Electronic Health Records

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  1. The Promise and Peril of Electronic Health Records CariWeishaar Final Project 12/8/11

  2. Health care costs are too high… Source: OECD 2009

  3. …and quality metrics are not better than other countries…

  4. “…IT must play a central role in the redesign of the health care system if a substantial improvement in health care quality is to be achieved in the next decade.” - Institute of Medicine, Crossing the Quality Chasm 2001

  5. Benefits of EHRs • Safety – Decision support tools can prevent adverse drug events caused by mistakes in prescribing • Efficiency – Patient information is better tracked thereby preventing redundancy of tests and procedures • Effectiveness – Automated reminders can make physicians and their patients more compliant with treatment plans and preventative care recommendations

  6. EHRs are made of many silos… • Practice Management System • Electronic Medical Record • Decision Support Tools • Patient Portal • Encounter Summary • Appts • ePrescribing • Legal Record of Pt Encounter • Lab Results • Billing • Labs and Procedures • Secure Emailing • …with only one interface.

  7. EHR Interface

  8. EHR Interface

  9. Interoperability • ePrescribing • Secure Emailing • Appts • Legal Record of Pt Encounter • Encounter Summary • Billing • Labs and Procedures • Lab Results

  10. EHR Adoption Rates Among Physicians

  11. Why aren’t adoption rates higher? • Misaligned incentives • Cost are incurred by the individual practices, benefits are diffuse • EHRs are expensive to maintain • Resistance to change • Learning to use the system is time consuming • Clinicians don’t want to be data managers! • Uncertainty about the future • Standards are still evolving • Too many choices (83 CCHIT certified Ambulatory EHRs in 2011)

  12. Appendix

  13. HITECH Funds • Incentive payments for meeting “meaningful use” • ePrescribing • Electronically exchange information • Clinical quality measures • Reduced Medicare/Medicaid reimbursement by 2015 providers who do not meet meaningful use • Finding for education, training and research

  14. Small practices are lagging

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