Electronic Health Record Systems

How do you start to lower the costs of medical care?

If you have ever had to deal with any insurance company and a group of medical providers you know they have about 10 different forms for everything and they don’t really like talking to each other. So here is a simple concept let’s all speak the same language.

Everyone in the medical professions must use the same method of record keeping. This includes all doctors, hospitals, clinics, pharmacies, government agencies, universities, insurance companies and employers. Now to really work well this should be national, but let’s just talk about Kentucky.

There needs to be a mandated uniform electronic health record system (EHR) in Kentucky. The biggest single, and currently growing, EHR system is used by the Veteran’s Administration. This works.

What is the up side?

The actual benefits can be summarized as follows:

EHR Systems

• It is estimated that over 5 years, EHR benefits will be $86,400 per provider and the benefits will be accrued by several stakeholders such as physician practices, ancillary services, pharmacies and most importantly patients
• Ohio State University Health System reduced the time for getting medication to patients by 65 percent from 5.28 hours to 1.51 hours. They also reduced Radiology turnaround from 7.37 hours to 4.21 hours
• Maimonides Medical Center reported 30.4 percent reduction in average length of stay from 7.26 to 5.05 days. They also realized organizational efficiencies by preventing duplicate ancillary tests
• Heritage Behavioral Health experienced 70 percent reduction in cost of clinical documentation with EHR
• University of Illinois at Chicago Medical Center gained significant benefits in reallocation of nursing time from manual documentation to direct care - estimated to be $1.2 million

e-Prescriptions

• Many errors occur because of handwritten prescriptions that can be easily misunderstood and can result in adverse drug events or complications. More than 3 billion prescriptions are written annually and according to an eHI report, medication errors account for 1 out 131 ambulatory care deaths and many deaths in acute care are also attributed to medication error.
• Studies indicate that the national savings from universal adoption could be as high as $27 billion annually

Computerized Provider Order Entry (CPOE)

• The Center for Information Technology Leadership (CITL) estimates that implementing advanced ambulatory CPOE systems would eliminate over 2 million drug events per year; avoid nearly 13 million physician visits, 190,000 admissions and over 130,000 life-threatening adverse drug events per year and save $44 billion per year.
• Brigham and Women's Hospital in Boston reported 55 percent reduction in serious medication errors and 17 percent reduction in preventable Adverse Drug Events (ADE) - average cost of an ADE was $2,595, resulting in projected savings of $480,000 per year. They estimated net savings from $5 million to $10 million per year.
• Maimonides Medical Center in New York realized 55 percent decrease in medication discrepancies and 58 percent reduction in problem medication orders. They also eliminated pharmacy transcription errors.
• Children's Hospital of Pittsburg has eradicated handwriting transcription errors completely and cut harmful medication errors by 75 percent.
  
  Will this be easy to do?
  
  No, there will be a lot of foot dragging, complaining, ego problems from the medical profession and actual computer glitches that would slow the implementation of such a system. But the real impediments to do this are greedy health providers and their lobbyists and the severe lack of a spine in most of our state legislators.