ALLERGY, RESPIRATORY
Folic Acid Might Offer Allergy Relief
Childhood Food Allergies on the Rise
Climate Change Could Sting Allergy, Asthma Sufferers
ALTERNATIVE MEDICINE
Imaging Sheds Light on How Acupuncture Works
The Zen Way to Pain Relief
Pharoah's Wine Jar Yields Medicinal Secrets
ANIMAL CARE
Beware of Dog Bites
Safe Toys for Dogs
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
BONES & JOINTS
Autumn Sees More Women With Bunion Problems
Human Ancestors Put Best Foot Forward 1.5M Years Ago
Frankincense Provides Relief for Osteoarthritis
CANCER
Adding Garlic Might Cut Cancer Risk
Smokeout '08: The Perfect Time to Quit
Physical Activity May Prolong Survival After Colon Cancer
CAREGIVING
Caregiving May Lengthen Life
Distance No Bar to Kidney Transplants in Remote Areas
ER Less Likely to Diagnose Stroke in Younger Folks
CIRCULATORY SYSTEM
Tai Chi and Qigong Offer Many Health Benefits: Review
Grapefruit-Heavy Diet Helped Spur Dangerous Clot
Firefighters Have Narrower-Than-Normal Arteries, Study Finds
COSMETIC
With Psoriasis, the Internet May Offer Hope
Wrinkle Fillers Need Better Label Warnings: FDA Panel
Health Tip: After Liposuction
DENTAL, ORAL
Gum Disease Treatment Doesn't Cut Preterm Birth Risk
Dental Implants Need More Work Than Root Canals
Hormones May Be to Blame for Women's Cavity Rates
DIABETES
Red-Grape Compound May Improve Diabetes
24 Million Americans Had Diabetes in 2007
Americans Consuming More Sugary Beverages
DIET, NUTRITION
Soluble Fiber, But Not Bran, Soothes Irritable Bowel
Atkins Diet Tougher on Heart After Weight Loss
The 3LS Wellness Program for Reversing Chronic Symptoms and Creating Lasting Health
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Golf Course Insecticides Pose Little Danger to Players
Meat-Eating Dinosaurs Used Legs and Arms Like Birds
Seasons Arriving 2 Days Earlier, Study Says
EYE CARE, VISION
Too Much Sun, Too Few Antioxidants Spell Eye Trouble
Kids Think Glasses Make Others Look Smart, Honest
Guard Kids' Eyes Against Long-Term Sun Damage
FITNESS
Living With Less TV, More Sweat Boosts Weight Loss
Go To Work But Skip The Car
Early Exercise Boosts Outcomes for ICU Patients
GASTROINTESTINAL PROBLEMS
Soothing Imagery May Help Rid Some Kids of Stomach Pain
Bowel Prep Harder on Women Than Men
New Guidelines Issued for Management of IBS
GENERAL HEALTH
Brisk Walk Can Help Leave Common Cold Behind
Healthy Living Adds Years to Life
Eating Healthy : You Can Live Longer
HEAD & NECK
Ski Helmets Encouraged for All
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
HEALTH & TECHNOLOGY
Combating Myths About Seasonal Allergies
Using Light Therapy to Silence Harmful Brain Activity
Imaging Sheds Light on How Acupuncture Works
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
Low Vitamin D Levels Linked to Heart Disease
Review Confirms Links Between Diet, Heart Health
After a Stroke, Light Exercise Gets Hands, Arms Working Again
INFECTIOUS DISEASE
Swine Flu Is Now a Pandemic Says W.H.O.
Chinese 'Devil Dung' Plant Could Be a Swine Flu Fighter
Surgical Masks Could Prevent Flu, Maybe
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Don't Leave Your Kids In The Car !
Obesity May Raise Kids' Allergy Risk
Older People at Greater Risk of Swine Flu Death
MEN'S HEALTH
Physical Activity May Prolong Survival After Colon Cancer
Drinking Green Tea May Slow Prostate Cancer
Varicose Veins May Mask Larger Problem
MENTAL HEALTH
Musicians' Brains Tuned to Emotions in Sound
Drink Away Dementia?
Common Social Groups and Race, Seem to Help People Relate
PAIN
Acupuncture, Real or Fake, Eases Back Pain
Are We Exercising Pain Away? Not So Much.
'Cell Phone Elbow' -- A New Ill for the Wired Age
PHYSICAL THERAPY
PREGNANCY
Alternative Treatments May Boost IVF Success
Mom's Extra Pregnancy Pounds May Raise Child's Heart Risks
Placebo Acupuncture Tied to Higher IVF Pregnancies
SENIORS
Common Antioxidant Might Slow Parkinson's
Mediterranean Diet Plus Exercise Lowers Alzheimer's Risk
As You Age, Better Health Means Better Sex
SEXUAL HEALTH
SLEEP DISORDERS
Pay Attention to Signs That Say You're Too Fatigued to Drive
Meditation May Help Put Primary Insomnia to Bed
Sleeping Could Help Women Lose The Baby Fat
WOMEN'S HEALTH
How Much Fish to Eat While Pregnant?
Supportive Weigh-In Program Keeps Pounds Off
Smoking Ups Risk of Second Breast Cancer
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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