Electronic Health Records Must Prove Their Worth

If adopting electronic health records does not improve the quality of health care Americans receive, as well as cut the soaring costs of health care, the digital records will become just one more large cost burden on the American health system, said Robert Kolodner, National Coordinator for Health Information Technology at the Department of Health and Human Services.

Kolodner, speaking at a conference in Washington, D.C., last week sponsored by Government Health IT magazine, said healthcare information technology can whittle down the nation’s health care bill, which accounted for about $2 trillion (15 percent) of the $13.2 trillion U.S. gross domestic product. But to do that, Kolodner said healthcare IT must drive “transformational changes” that improve both quality and efficiency.

Transformational changes should improve the quality and efficiency of health care, Kolodner said. He cited the Veterans Health Administration, where Kolodner served as chief health informatics officer at VHA before joining HHS, as an example. VHA, he said, used its electronic health record system to help identify patients at risk of contracting flu or pneumonia. The VHA sent electronic reminders to clinicians caring for the patients identified as being at risk to ask the clinicians to immunize annually the patients with flu and pneumonia shots. Kolodner says the program avoided 6,000 deaths in the 1990s.

Kolodner envisions future healthcare IT systems that combine electronic health records with genetic records that will allow clinicians to pinpoint care in a way never done before in a process he called “mass customization” of medical records. This will lead to the practice of patient-centric based medicine, replacing today’s provider-centric system, which provides care based on symptoms, he said.

The Bush administration has set a goal of providing at least half the U.S. population with electronic records by 2014. The Office of the National Coordinator for Health Information Technology is in the process of developing a patient privacy framework, which takes into account multiple state and federal laws covering medical privacy. The framework allows states and localities to decide on whether patients can either opt in or opt out to electronic health records systems.

The challenges of building a system of electronic health records and the high risks that such a system imposes has been questioned by IT experts, such as a column last year in CIO Magazine.