When President Obama signed the
American Recovery and Reinvestment Act of 2009 (ARRA) almost a
year ago, healthcare industry experts hailed the portion
providing $19 billion in government incentives to accelerate
the adoption of electronic medical records (EMRs). Supporters
touted the measure as a means of saving the U.S. healthcare
system up to $100 billion a year with widespread conversion.
However, recent evidence presents a different picture of the
benefits of EMR adoption, and now further analysis is being
undertaken to determine the actual effects on cost and quality
of care.
The benefits to EMR adoption are
evident, although to what extent they can affect overall
healthcare costs is still yet to be determined. Converting
from traditional information methods to an EMR-based system
can reduce medical errors, enhance access, eliminate redundant
testing, allow for better measurement of quality, improve
efficiency, and augment clinical care. But while such measures
can control claims costs and in the process minimize premium
increases, EMRs in their current form may not have the
financial impact that supporters and policy makers are
expecting.
A recent study by the Center for Studying Health System
Change found that current commercial EMRs are
better for billing and documentation than they are for
improving coordination of medical care – which is where the
potential for healthcare savings is more prominent. According
to the research, current EMR design is driven by clinical
documentation needs as they relate to billing rather than
patient and provider needs in relation to clinical management.
Current designs also make it more difficult to communicate and
exchange patient data across physician practices and different
care settings.
Another
study comparing 3,000 hospitals at various
stages of EMR adoption found little difference in the cost and
quality of care, but more as a result of the hospitals’ lack
of effective use. According to author Dr. Ashish K. Jha, the
way hospitals are currently using the technology is having a
marginal effect on quality or cost, and until more focus is
directed toward education, the true benefits of EMR adoption
may not be realized.
With only 20% of physician’s
offices across the U.S. fully integrating EMR systems into
their practices, the road to widespread adoption continues to
be an uphill battle. Further government incentives and other
measures through anticipated healthcare reform could increase
the adoption rate, but if concerns about integrating and
standardizing EMR systems as well as educating on proper usage
are not addressed, the immediate return in terms of improving
cost and quality of care may not live up to earlier
expectations. Thus, if market demand is impeded by these
limitations, it may be some time until we can fully evaluate
EMRs true impact on healthcare costs.
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