Ron Sims, Rich Moyer, Gail Graham, and Scott Armstrong continue to respond to Wednesday’s question about adoption of electronic health records.
Ron Sims: The original question was, “Who is going to come with the standards?” And I believe you’re going to see the Federal Government move on them with a great deal of aggression over the next couple of years, and there’s several reasons why. If you look at the issues that the three car companies face, one of the things that they’ve been raising on a pretty consistent basis is their healthcare costs, not only their pension costs, but their healthcare costs.
Jim Schibanoff of the Milliman Care Guidelines, Scott Armstrong of Group Health, John Hammarlund of CMS, and Joe Scherger of Lumetra discuss physician adoption of electronic health records.
Q: Jim Schibanoff, we’ve talked a bit about the cost and investment requirements of adopting these systems. I’m curious also about the impact on providers of learning these new systems, learning how to use them effectively. Is this potentially a larger burden for healthcare providers?
Jim Schibanoff: Well, it’s great to hear Scott describe Group Health’s experience, the after, because most physicians are dealing with the before, which they see as great disruptions to their routines of care, more inefficiencies in their practices. They feel under financial pressure already and here it’s taking more time to use this electronic health record. So getting over that hump is a significant issue. And in systems like the VA, Kaiser, I believe Group Health, there is much more of a group culture. There’s a financial mechanism, a delivery mechanism. The physicians are more integrated into the system, as opposed to all the physicians in private practice who are in one or two physician offices and may go to one or two hospitals.
Mike Kreidler, John Hammarlund, George Scriban, Scott Armstrong, and Ron Sims discuss EHR as a catalyst for healthcare reform, responding to a question submitted by Cody Augdahl.
For submitting this question, Cody Augdahl is a finalist in our question contest. Congratulations, Cody.
Q: I have another question that came from someone who submitted one before the event; it was submitted via e-mail. It’s kind of an interesting question. It asks us to imagine the day when, in fact, a majority of the U.S. population has adopted personally controlled health records. What kind of impact would that have more broadly on the system potentially, do you think? I mean, it’s a little bit hard to put ourselves out there and imagine the circumstance, Mike, but could you see how that might be a catalyst for other change?
Mike Kreidler: I think you need a great deal more transparency in the system than you have right now, and that’s one of the real problems. You can’t even do any accounting in the system right now because of the variation that you have.
Scott Armstrong, Group Health CEO, addresses this question.
Barry: What can electronic health records do for us? Scott Armstrong at Group Health, I understand that you’ve been using electronic records for some time. How’s it going?
Scott Armstrong: Well, thanks, Barry. We, as you said, we have been using electronic records in our care delivery system for more than four years now. This is thousands of terminals in our medical centers all across the state.
Scott Armstrong, Group Health CEO, addresses this question submitted by Drew Campbell via LinkedIn.
For submitting this question, Drew Campbell is a finalist in our question contest. Congratulations, Drew.
Barry: Scott, I have a question from a tech manager at Group Health. He submitted a question via LinkedIn. Maybe you could take this. “My question stems from changing doctors, which I’ve been forced to do due to changing companies, and thus health plans and physicians. It has been very difficult to get my records to the new doctor, which is my health information, not the doctor’s. How will making these records electronic facilitate migration of this information from one doctor to another? Are there concerns from the doctors that they will not be able to charge as much due to getting a more complete historical record than they’ve had in the past? Or will they not use the information and still re-evaluate any diagnosis? How much trust is there in the community of doctors between doctors?”
Scott Armstrong: Well, Barry, this question goes back to the discussion we were having earlier about the portability of this information. In our healthcare system, we have not solved for this. This is something that I am sure will be addressed in the years ahead, but it’s a big issue.
Will electronic health records (EHRs) minimize mistakes that may arise from sloppy handwriting and illegible files? How do we certify the accuracy of patient-provided health information?
Q: How do you resolve issues from inaccurate information in these records?
Gail Graham: I don’t think this a different problem than we had in paper, actually—if you have patients who are not the best historians at the time, for example, or if people forget what allergies they have. You have them admitted in different states and their family providing the information. We had a lot of questions about this from our providers as we bring in other information. What we’ve decided to do is really make it clear where this information came from. Was this a physician? Was this a nurse? Was this a pharmacist? So that the clinician looking at the information can make some judgment calls on the validity of the information. Continue reading →
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