tech time

Electronic Health Records

How will technology impact the perilous path to tomorrow?

SCOT MORRIS, O.D., F.A.A.O.

Recently, Electronic Health Records (EHR) moved to center stage, largely because of the realization that our health system is failing due to overwhelming expenses and operational inefficiencies. National Health Expenditures projections estimate that healthcare costs will increase at a rate of 6.7% per year and that by the year 2017, 19.5 cents of every U.S. dollar spent in this country will be related to health services. In less than nine years, the average American will spend $13,101 a year on health care, according to these estimates. Savings and efficiencies from technology may be the only way to save health care as we know it.

While we have yet to see how, specifically, EHR will affect optometry, there is little question that we are about to undergo major healthcare reform. Are we prepared? Let's look at a few basic facts about the "now."

Where are we?

The American Health Information Community estimates that less than 12% of U.S. hospitals and only 4% of general primary-care practices have adopted fully integrated EHR systems. (Fully integrated systems link practice management and clinical management tools, such as billing, scheduling, inventory management, claims processing and recall.) The 2007 American Optometric Association New Technology Survey reveals that only 25.9% of eyecare practices use EHR. Also, it's estimated that only 24% of these practices (6.5% of eyecare practices) use fully integrated EHR systems.

The remaining 74% of optometric practices have yet to implement some kind of EHR software, which will be required to comply with upcoming national healthcare regulations. And, no single technology provider can handle that workload.

EHR is essential to value-driven medicine, as it streamlines clinical care and prevents mistakes that could cost millions of lives and trillions of dollars. Further, I can't imagine my practice without EHR. Paper systems would double my costs and halve my efficiency.

A ways to go

EHR has a ways to go. Some systems have moved in the right direction, yet activities, such as scheduling and product ordering, must be more interactive and Webbased. Though I can book a dinner reservation, airline ticket and movie pass on the Web, I still can't easily make a doctor's appointment online. One of the largest hurdles for current EHRs is the simple, interactive and instantaneous communication among providers, patients and payers.

Value-driven healthcare will necessitate rapid and seamless communication. E-prescribing will be a positive first step, but most vendors are still struggling with this across the medical spectrum.

What to expect

When can we expect EHR to be mandatory? The National Health Information Infrastructure has set a deadline of 2015 (though pundits say it will take longer — REALLY?) Beginning with HIPAA in 1996, the government has taken steps toward value-driven medicine. The Physician Quality Reporting Initiative and e-prescribing are other small parts of this process.

The proverbial rock has been rolling down hill for a while. Many are watching, but few are preparing for the impact. OM

Next month we dive into the concepts of value-based medicine.