ALLERGY, RESPIRATORY
Herbal Remedy Could Halt Peanut Allergy
Traffic, Dust Linked to Asthma in Kids
Combating Myths About Seasonal Allergies
ALTERNATIVE MEDICINE
Bitter Melon Extract May Slow, Stop Breast Cancer
Yoga May Bring Calm to Breast Cancer Treatment
Eight Spiritual Universal Principles in the Art of Practice
ANIMAL CARE
'Comfort Dogs' Come to Emotional Rescue
Animals Respond to Acupuncture's Healing Touch
Separation Anxiety, Canine-Style
BONES & JOINTS
B Cells Can Act Alone in Autoimmune Diseases
Yoga Can Ease Lower Back Pain
Pain More a Cause of Arthritis Than a Symptom
CANCER
Green Tea May Help Prevent Oral Cancer
HPV Vaccine Has Higher Allergic Reaction Rate
Drinking Green Tea May Slow Prostate Cancer
CAREGIVING
Caring for Aging Loved Ones Can Be a Catch-22
Diabetes Epidemic Now Poses Challenges for Nursing Homes
Moms Who Breast-Feed Less Likely to Neglect Child
CIRCULATORY SYSTEM
Grapefruit-Heavy Diet Helped Spur Dangerous Clot
Bye, Bye Back Fat?
Smog Tougher on the Obese
COSMETIC
Health Tip: After Liposuction
Mouse Study Finds Molecule That Tells Hair to Grow
The Acne Drug Accutane More Than Doubles Depression Risk
DENTAL, ORAL
Most Insured Adults Worry About Health Care Costs: Poll
Gum Disease May Reactivate AIDS Virus
A Sweet Way to Shield Baby's Teeth
DIABETES
Vitamin K Slows Insulin Resistance in Older Men
Fructose-Sweetened Drinks Up Metabolic Syndrome Risk
24 Million Americans Had Diabetes in 2007
DIET, NUTRITION
More Calcium And Dairy Products in Childhood Could Mean Longer Life
Weight Loss Might Not Curb Knee Arthritis
Adults Need To Get Thier Food Facts Straight
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Improved Fungicides May Be Easier on Environment
Database Helps Assess Your Breast Cancer Risk
Green Areas Lower Health Inequities Between Rich, Poor
EYE CARE, VISION
When Gauging Age, the Eyes Have It
It's a Whole New Outlook for Cataract Patients
High Temps Degrade Contact Lens Solution: Study
FITNESS
Simple Steps Get Walkers Moving
Almost Two-Thirds of Americans Meet Exercise Guidelines
Strenuous Daily Workout May Keep Cancer at Bay
GASTROINTESTINAL PROBLEMS
HRT Use Raises Risk of Stomach Trouble
Intestinal Bacteria Trigger Immune Response
New Yogurt May Ease Stomach Ulcers
GENERAL HEALTH
Keep Fire Safety in Mind as You Celebrate
Most Women Struggle With Rising Health Care Costs
Vitamin D and Bone Health: Are You Getting Enough of This Important Vitamin?
HEAD & NECK
Zen May Thicken Brain, Thwart Pain
Ski Helmets Encouraged for All
Many Children Will Outgrow Headaches
HEALTH & TECHNOLOGY
Imaging Sheds Light on How Acupuncture Works
'Cell Phone Elbow' -- A New Ill for the Wired Age
Airport Full Body Scanners Pose No Health Threat: Experts
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Arteries Age Twice as Fast in Smokers
Boosting Vitamin D Can Do a Heart Good
Dark Chocolate May Lower Stroke Risk
INFECTIOUS DISEASE
Swine Flu Loves a Crowd
Swine Flu Closes Three Schools in NYC
Hand Washing 10 Times a Day May Help Keep Flu Away
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Breast-Feeding May Protect a Woman's Heart
Family Medicine Cabinet Top Source Of Kid's Poisonings
Time to Remind Teens About Sun Protection
MEN'S HEALTH
Eating Fast Until Full Triples Overweight Risk
The Dark Side of Vegetarianism
Noise Hurts Men's Hearing More, Study Shows
MENTAL HEALTH
How to Attack Holiday Stress Head-On
Psychotherapy Can Boost Happiness More Than Money
Most Depressed Teens Don't Get Treatment
PAIN
Acupuncture, Real or Fake, Eases Back Pain
Are We Exercising Pain Away? Not So Much.
Alleviating Rheumatoid Arthritis
PHYSICAL THERAPY
PREGNANCY
Exercise Boosts Bone Density in Breast-Feeding Moms
Heart Defects in Newborns Linked to Antidepressants
Sugary Colas Tied to Gestational Diabetes
SENIORS
High-Impact Activity May Be Good for Old Bones
Tai Chi May Help Ward Off Knee Pain in Seniors
Tai Chi and Qigong Offer Many Health Benefits: Review
SEXUAL HEALTH
SLEEP DISORDERS
Moderate Aerobics May Ease Insomnia Symptoms
Lose Weight, Sleep Apnea May Improve
Meditation May Help Put Primary Insomnia to Bed
WOMEN'S HEALTH
Exercise During Pregnancy Keeps Newborn Size Normal
Soy May Not Lead to Denser Breasts
Prenatal Stress May Boost Baby's Asthma Risk
Add your Article

Few Hospitals Embracing Electronic Health Record Systems

WEDNESDAY, March 25 (HealthDay News) -- Only a small number of hospitals in the United States have comprehensive electronic health record systems currently in place, a new study finds.

The biggest obstacle to adopting such systems is the cost, which can run as high as $20 million to $100 million, plus the reluctance of doctors to change their ways, experts say.

"President Obama, members of Congress and other policymakers have been pushing the notion that we need to have electronic records in hospitals and doctor's offices to make our health-care system work better," said lead researcher Dr. Ashish K. Jha, an associate professor at the Harvard School of Public Health.

But few hospitals have adopted these systems, Jha noted. "Achieving the vision of having electronic health care records deployed widely across the health-care system, we have a very long way to go," he said.

The report is published in the March 25 online edition of the New England Journal of Medicine.

For the study, researchers questioned 3,049 U.S. hospitals about their electronic health record systems. They found that only 1.5 percent of these centers had comprehensive systems. A comprehensive system was defined as hospital-wide clinical documentation of cases, test results, prescription and test ordering, plus support for decision-making that included treatment guidelines.

Almost 8 percent of hospitals have an electronic records system that includes physician and nursing notes, but these systems do not have decision support. Some 10.9 percent have a basic system that does not include physician and nursing notes, and can only be used in one area of the hospital. When looking at computerized prescribing, the researchers found that 17 percent of the hospitals had this capacity, the researchers found.

The staggering cost of these systems has been a deterrent: The researchers noted that many hospitals don't have the resources to pay for them and there is no way to recoup the investment. "Hospitals don't get any more money for implementing these systems," Jha noted.

The researchers did not include federal hospitals in their analysis, since the Veterans Affairs hospitals have already implemented comprehensive electronic health record systems.

Jha noted that the recently passed stimulus bill includes $19 billion for promoting electronic medical records. "I think that's a great start, but given how low adoption rates are, it's just a start. It will help some hospitals get over the hump, but for many institutions, if the government really wants to help create incentives it's going to have to put a lot more resources into this area," he said.

The federal government can also base payments on improved quality of care rather than quantity of care, Jha said. Contrary to common belief, electronic health care record systems may not save money. "The jury is still out on that -- it might. There is very convincing evidence that this technology is going to make care safer, it's going to make care better," he said.

Money is only one issue slowing down the adoption of these electronic systems. Physician resistance and the lack of universal standards are also reasons cited by hospitals for not instituting these systems, Jha said.

Getting all hospitals to adopt electronic medical record systems will not happen overnight, Jha reasoned. "Even in the best-case scenario, it's going to take five to 10 years," he said.

Dr. David Blumenthal, director of the Institute for Health Policy and a physician at Massachusetts General Hospital/Partners HealthCare System, Boston, said during an afternoon teleconference Tuesday that the government is trying to soften the financial blow of adopting systems.

"The Congress and the administration showed enormous foresight and commitment to the goal of increasing adoption rates through the provisions of the stimulus bill," Blumenthal said. "The Congress wants to see results for the American people in terms of health and health care, not just in terms of technology adoption."

Blumenthal served as an advisor to the Obama campaign; in mid-April Blumenthal takes up his new job in the U.S. Department of Health and Human Services as the National Coordinator for Health Information Technology.

But two other researchers believe there's a long way to go in lowering the cost of implementing electronic medical record systems while also making them more flexible.

Current electronic record systems are monolithic, and they either fit the practice well ort hey don't, said Dr. Isaac S. Kohane, a professor of pediatrics and medicine at Harvard Medical School, co-director of the school's Center for Biomedical Informatics, and co-author of an accompanying journal article. If the system doesn't fit, "you are engaged in a costly customization process," he said.

Kohane and his co-author Dr. Kenneth Mandl, an associate professor at Harvard-MIT Division of Health Sciences and Technology, contend that using a platform of modular programs that can be made available through the federal government would allow hospitals to pick and choose the applications that best suit them, much like people now select the options they want from Google, Facebook and other Web sites.

"What we have is an opportunity to take a rational approach to what the characteristics are of a national system that would allow a standardized method of substitutable applications to access a core set of data to drive improvements in health care," Mandl said.

In addition, these applications should be less expensive than current systems, Kohane said.

-Steven Reinberg

More information

For more information on electronic medical records, visit the U.S. Centers for Disease Control and Prevention.



SOURCES: Ashish K. Jha, M.D., M.P.H., associate professor, Harvard School of Public Health and Harvard Medical School, Boston; Isaac S. Kohane, M.D., Ph.D., professor, pediatrics and medicine, Harvard Medical School, and co-director, HMS Center for Biomedical Informatics, Boston; Kenneth Mandl, M.D., M.P.H., associate professor, Harvard-MIT Division of Health Sciences and Technology, Boston; March 24, 2009, teleconference with: David Blumenthal, M.D., M.P.P., director, Institute for Health Policy and physician, The Massachusetts General Hospital/Partners HealthCare System, Boston; March 25, 2009, New England Journal of Medicine, online

Last Updated: March 25, 2009

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