EHR Promises Yet to Be Realized

December 1, 2015

Electronic health records (EHRs) were to bring us reductions in cost and, just as importantly, seamless record-sharing between health-care providers. “Epic Fail” at Mother Jones explains why that has yet to happen. The short answer: despite government’s intentions, federation is simply not part of the Epic plan; vendor lock-in is too profitable to relinquish so easily.

Reporter Patrick Caldwell spends a lot of pixels discussing Epic Systems, the leading EHR vendor whose CEO sat on the Obama administration’s 2009 Health IT Policy Committee, where many EHR-related decisions were made. Epic, along with other EHR vendors, has received billions from the federal government to expand EHR systems. Caldwell writes:

“But instead of ushering in a new age of secure and easily accessible medical files, Epic has helped create a fragmented system that leaves doctors unable to trade information across practices or hospitals. That hurts patients who can’t be assured that their records—drug allergies, test results, X-rays—will be available to the doctors who need to see them. This is especially important for patients with lengthy and complicated health histories. But it also means we’re all missing out on the kind of system-wide savings that President Barack Obama predicted nearly seven years ago, when the federal government poured billions of dollars into digitizing the country’s medical records. ‘Within five years, all of America’s medical records are computerized,’ he announced in January 2009, when visiting Virginia’s George Mason University to unveil his stimulus plan. ‘This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests.’ Unfortunately, in some ways, our medical records aren’t in any better shape today than they were before.”

Caldwell taps into his own medical saga to effectively illustrate how important interoperability is to patients with complicated medical histories. Epic seems to be experiencing push-back, both from the government and from the EHR industry. Though the company was widely expected to score the massive contract to modernize the Department of Defense’s health records, that contract went instead to competitor Cerner. Meanwhile, some of Epic’s competitors have formed the nonprofit CommonWell Health Alliance Partnership, tasked with setting standards for records exchange. Epic has not joined that partnership, choosing instead to facilitate interoperability between hospitals that use its own software. For a hefty fee, of course.

Perhaps this will all be straightened out down the line, and we will finally receive both our savings and our medical peace of mind. In the meantime, many patients and providers struggle with changes that appear to have only complicated the issue.

Cynthia Murrell, December 1, 2015

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