The Federal Government Has Put Billions into Promoting Electronic Health Record Use: How Is It Going?

Author(s): Brian Schilling The Commonwealth Fund, 2011

The Commonwealth Fund

In 2009 as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, the federal government set aside $27 billion for an incentive program that encourages hospitals and providers to adopt electronic health records systems (EHR). Billions more were allocated to help train health information technology (HIT) workers and assist hospitals and providers in setting up EHRs that would enable the health data historically sequestered in paper files to be shared among providers and used to improve health care quality.

Hundreds of studies of EHRs and decision support systems across the country have demonstrated the benefits of such tools. EHRs can slash drug-drug interaction rates, decrease mortality rates among the chronically ill, cut nurse staffing needs, and lower costs. A 2011 meta-analysis of HIT-implementation studies found that 92 percent of published reports to date had predominantly positive results. Yet the adoption of HIT in the U.S. has been slow. Only about 10 percent of physicians use what might accurately be described as a fully functioning electronic medical record system, while slightly more than 50 percent have at least partial EHR systems in place. By contrast, 90 percent of doctors in the Netherlands, the United Kingdom and New Zealand use EHRs.

Implementing an EHR is not cheap. Cost is frequently cited as the main obstacle to broader adoption of such systems, but it's not necessarily the cost of an EHR system itself that gives many physicians pause. Instead, the more significant cost involved may be lost revenue incurred during the months of preparation, planning, training, and workflow redesign that typically comes with switching to an EHR.

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