Why electronic health records have far to go

Rather than being a hit piece at the current Administration's aims, the report focuses on the best practices of groups like Kaiser Permanente and the Cleveland Clinic, which have spent years adapting their work to the technology. Do these things and you can make things work.

It's easy to seize on word that electronic health records (EHR) are not yet saving money and call everything the Obama Administration is doing in health care bogus.

That would be unfair to the technology.

Ashish Jha of the Harvard School of Public Health offered the report this week as a scene-setter for the school's Public Health and Technology (PHAT) conference, whose speakers' list is a who's who of EHR advocates. (Picture from Dr. Ashish Jah's home page at Harvard.)

Rather than being a hit piece at the current Administration's aims, the report focuses on the best practices of groups like Kaiser Permanente and the Cleveland Clinic, which have spent years adapting their work to the technology. Do these things and you can make things work, as proven in areas like heart care, he writes.

Rather than focusing on paying for the computers and software, he says, emphasis should be placed on training people, and adapting practices to take advantage of what the data can do. As in any business a failure to adapt means you're wasting money.

Dr. Jha made this point in the School of Public Health's in-house publication last month. Speaking at a University-sponsored public forum in September, he said this:

The money in the stimulus bill is going to help a lot in terms of getting systems adopted. You’re going to see this entire field change dramatically in the next several years. You’re going to see new vendors getting into this field who haven’t been there before. I’m hopeful this will mean better products that will require less training. There’s no doubt in my mind that five years from now, we are going to have far more widespread use of electronic health records.

Whether we are going to get to 90% as President Obama has said he wants, I’m not sure. But the bottom line is that this train has left the station. We’re moving towards electronic records. The only question is whether we can do it well. The big challenge for us is to make sure we adopt these systems effectively, that we remember the prize is not electronic records; the prize is higher quality at lower cost. And that’s only going to happen if we really think through how to adopt these systems in a more organized and effective way.

Those are the words of an EHR enthusiast, not a skeptic, and certainly not a cynic.

Fact is the EHR revolution has barely begun. The Health Internet is still being implemented. Barely one hospital in 10 has a functioning EHR system. Moore's Law of Training (there is no Moore's Law of Training, we learn as fast as we learn) has barely kicked in.

The health IT revolution will not happen like the turning on of a light switch, as people in every other industry that has been touched by computers, including journalism, will tell you.

It's a long-term process.