Health IT Status Report 2008: Straight Talk on Healthcare Technology from C. Peter Waegemann, CEO of the Medical Records Institute

Commentary by C. Peter Waegemann, CEO of the Medical Records Institute.

The Medical Records Institute released yesterday “The HIT Status Report 2008,” the latest version of its annual “state of the union” review of notable health information technology developments in the past year and preview of stories to watch for in 2009.

“The HIT Status Report 2008” takes stock of recent developments in health IT that “represent system restructuring, new information technology solutions, and a revolution in doctor—patient communications.” The report provides “a high-level summary of these developments” and offers “a clear assessment of what we can realistically expect in terms of success.”

Several surprising statements and assertions from the report include:

• While wondering “how many remaining Regional Health Information Systems (RHIOs) will survive beyond 2009, with some having already collapsed and many others struggling,” the report also states that if one defines an EHR as a regional system that requires “full interoperability among all healthcare providers and wellness stakeholders,” then it is safe to say that “not only have such systems failed in the US, few EHRs providing full interoperability among numerous providers of care and wellness are well functioning anywhere in the world,” including Europe.

• The picture isn’t much better when one contemplates adoption rates for electronic medical record (EMR) systems, defined in the report as systems “based in a specific enterprise of a provider, whether a clinic, a hospital, or a doctor’s office.” The report pronounces our implementation success as “dismal,” citing a report by the Office of the National Coordinator for Health Information Technology published in the New England Journal of Medicine that found “only four percent of physicians have an “extensive, fully functional electronic record system and 13% have a basic system.”

• The report also says that the common perception that larger institutions are ahead of smaller and solo practices in implementing EMRs is “another myth that needs to be corrected.” Although “most hospitals have substantial computer systems and many of their patient care processes are computerized, hospitals are not way ahead in their EMR implementations. If one requires that an EMR system include all documentation in digital format and be totally paperless, then somewhere between 2% and 12% of hospitals have such a system (or part of such a system).”

• EMR implementation will not in and of itself lead to immediate cost savings. Calling out the “bloggers and healthcare experts” who are basing their calls for greater government expenditure to promote EMR implementation on shaky data from “academic and somewhat misleading surveys,” the report asks “where is the clear evidence that it is wise” to spend billions of dollars on EMRs? The report argues that substantive cost savings can only be achieved “through a restructuring of healthcare,” and cautions that although EMRs “may well be tools in the restructuring process, …they should not be perceived as the main tool or goal and we should not have such unrealistic expectations of them.”

There is a lot more where this came from, including commentary on personal health records and ideas and strategies for real cost savings through health IT. Go read the full version of the report.