CMS Acting Administrator Andy Slavitt speaks to moderator Janet Marchibroda of the Bipartisan Policy Center about changes that need to be made to electronic health record systems.
Despite the huge investments in money and energy that have been poured into transitioning to electronic health records (EHRs), physicians are still often unable to easily share crucial patient information with each other.
Two senators recently joined federal officials at a forum hosted by the Bipartisan Policy Center(bipartisanpolicy.org) to discuss what stands in the way of greater interoperability among different EHR systems. It's an urgent question, because the federal government already has spent $31 billion to encourage the adoption of EHRs, but the limited ability of the systems to share information remains high on physicians' list of frustrations.
According to a new report(www.bipartisanpolicy.org) by the Bipartisan Policy Center, the percentage of physicians who reported sharing patient information with hospitals is low. Eighteen percent said they shared information with affiliated institutions and just 9 percent did so with unaffiliated institutions. Only 20 percent of physicians shared lab results with affiliated health professionals and just 14 percent did so with unaffiliated professionals.
- Senators and federal officials discussed roadblocks to interoperability of electronic health record (EHR) systems during a recent forum hosted by the Bipartisan Policy Center.
- The lack of interoperability can lead to problems such as duplicate testing and risks to patients, panelists said.
- Proposed legislation would establish a system to allow physicians to evaluate the quality of EHR systems.
"It's not technology that's holding us back; it's business practices," CMS Acting Administrator Andy Slavitt said at the forum. "Hospitals are not sharing data. The technology is not on an open platform, but we have solved more complex technology challenges than this."
The banking industry, for one, has solved a similar problem. Speakers at the forum pointed out that although one bank's ATM can easily communicate with another bank, such seamless communication is not available between medical institutions. That leads to problems such as duplicate testing and risks to patients.
Elected officials are concerned about the interoperability problem. Sen. Bill Cassidy, M.D., R-La., said during the forum that the time required to input and process patients' EHR data hurts productivity for small practices.
"If you are that family practitioner who is dependent upon the number of patients you see in order to make ends meet, the fact that productivity is decreasing by 25 percent makes you less likely to stay in that small practice in a rural setting and more likely to go to a large institution," he said.
Cassidy then cited survey data showing that EHRs are one of the leading causes of dissatisfaction among physicians. Forty-five percent of physicians said patient care suffers because of EHRs, according to one survey.(medicaleconomics.modernmedicine.com)
"The way EHRs have been rolled out has been for the benefit of vendors and billers and not for patients and physicians," Cassidy said.
He cited another study(link.springer.com) in which interns said they spend 12 percent of their time on direct patient care and 40 percent of their time documenting it.
Cassidy and Sen. Sheldon Whitehouse, D-R.I., who also attended the forum, have sponsored legislation that would introduce new EHR standards to address many of the concerns about information-sharing. The Transparent Ratings on Usability and Security to Transform Information Technology Act(www.whitehouse.senate.gov) would require the Office of the National Coordinator for Health Information Technology to establish a ratings system that would allow physicians to evaluate the quality of EHR systems. The legislation would allow physicians and other health care professionals to provide feedback on system performance confidentially. Currently, some IT vendors impose gag rules on physicians to prevent them from reporting on any program flaws to other physicians.
Whitehouse noted that if such problems are fixed, EHRs have great potential to improve patient care. One physician, he said, told him, "I hated going through my EHR process, but I would never go back."
Whitehouse said he sees positive signs. Both parties, he said, are now able to agree on changes to health care policy in a number of areas without rancorous debate, something he said was not possible three years ago.
"We're at the nuts and bolts stage in terms of how health IT will improve the health system," Whitehouse said.
Related AAFP News Coverage
Meaningful Use a 'Program in Crisis'
AAFP Urges HHS to Pause, Refocus, Streamline MU Program