The Department of Health
and Human Services (HHS) has released a plan to help health care providers
use technology to manage their records and information. The plan calls for
all health care providers to use electronic health record systems by the
end of the decade.
HHS will award an estimated $50 million in grants to
nine communities this fall to develop electronic records systems and
interchanges. The funding, which is designed to offset the costs of
developing and implementing such systems and encourage providers to make
the investment, is expected to double next year. The nine communities are:
Denver; Indianapolis; Milwaukee; the Baltimore/Washington, D.C.
metropolitan area; Santa Barbara, CA; Fishkill, NY; Kingsport, TN;
Bellingham, WA; and Waltham, MA.
HHS’s plan includes statistics showing that, at
present, only 13% of hospitals and about 20% of physicians have electronic
systems. Making all records electronic is expected to help reduce the
number of medical errors, which often are caused by harmful drug
interactions or mistaken handwriting. Another improvement, according to
HHS, would be greater efficiency for doctors and hospitals.
One component of HHS’s plan is the identification
of standards for electronic records systems that will enable providers to
access records created by other physicians or hospitals. Another is the
possibility of offering grants to help defray the costs of implementation,
and basing reimbursement someday in part on whether the facility uses
electronic records.
Hospital officials reacted positively to the plan, but
they also cited concerns that the government follow through on its promises
of financial incentives to convert to electronic systems, and that the
national standards protect patient privacy. The cost to purchase and
implement electronic records systems is in the millions, they noted, but so
far the financial benefit is yet to materialize. Even so, as long as
electronic systems have three features – many options to access the
system, simplicity of use, and accurate information – hospital
officials said physicians will quickly become advocates and that, 10 years
from now, electronic systems will be the norm.
Uninsured Patients Tax EDs
According to a report released in August by the
National Association of Community Health Centers, patients lacking health
insurance are flooding U.S. hospital EDs, with many seeking routine care
that they should get elsewhere. The report found that the number of visits
to hospital EDs increased from 89.8 million in 1998 to 110.2 million in
2002, while the number of EDs decreased by 15% over the same period.
An estimated 43 million Americans lack health
insurance. They either go without health care or they rely on nonprofit,
community centers. Their only other alternative is to visit EDs which, by
law, must provide basic, needed care.
For its study, the Association examined data provided
to HHS by about 1,000 federally funded community health centers. It found
that the number of uninsured patients getting care at the centers, which
must provide care regardless of ability to pay, grew by 11% during 2003
alone. “Some health centers are experiencing an explosion of
uninsured patients as high as 73 percent, and due to a weakened economy and
state budget cuts, no letup is in sight,” the report states. In
attributing the trend to a decrease in the number of physicians who accept
patients enrolled in Medicaid as well, the report continues, “Fewer
doctors open their doors to patients who rely on Medicaid. One-fifth is not
accepting any new Medicaid patients.”
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