Hospitals' Electronic Wasteland

Stimulus funds aim to change a system largely devoid of in-depth electronic record keeping.

Less than 2 percent of U.S. hospitals today use comprehensive electronic health records, according to a new survey of 3,000 hospitals that highlights just how far the health-care system has to go to meet President Obama's goal of providing every American with access to electronic records by 2014.

Credit: Technology Review

Experts involved in the study, headed by David Blumenthal, Obama's newly appointed national coordinator for health information technology, say that the $19 billion in funding for health-care information technology and other provisions outlined in the new stimulus bill will directly address the two major hurdles to adoption--the cost to implement and maintain the records, and the difficulty of exchanging information among various health-care providers' differing computer systems.

"Those provisions try as directly as possible to address some of the barriers highlighted in the research," said Blumenthal, a physician who currently serves as the director of the Institute for Health Policy at Massachusetts General Hospital (MGH) in Boston, at a press conference this week. He will assume his new post in April, leading an office within the Department of Health and Human Services--the Office of the National Coordinator of Health Information Technology--which was made permanent by the stimulus legislation.

According to the findings, published Wednesday in the Journal of the American Medical Association, about 8 percent of U.S. hospitals use basic EHR systems--which include patient demographics, medical complaints, medications, and some test results--in at least one department. Only about a quarter of those are using comprehensive EHR systems, including so-called decision support systems, which assist physicians and other health-care providers in making treatment decisions, for example, reminding them to prescribe pre-operative antibiotics.

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"If the goal of [electronic record] adoption is to improve quality of care, then this kind of decision support can help clinicians provide the right care more often," said Cait DesRoches, a public health expert at the Institute for Health Policy at MGH and one of the authors of the study, at the press conference.

Individual electronic functions are more common--about 16 percent of hospitals use electronic ordering systems for medications, while more than three-quarters of respondents reported using electronic systems for the results of laboratory and radiology tests.