ALLERGY, RESPIRATORY
Climate Change Could Sting Allergy, Asthma Sufferers
Obesity May Raise Kids' Allergy Risk
Asthmatics Who Quit Smoking May Reverse Lung Damage
ALTERNATIVE MEDICINE
Memory Loss Help from Brain Supplement Prevagen
When Healing Becomes a Commodity
Naprapathy: A Hands-On Approach to Pain Management
ANIMAL CARE
Animals Respond to Acupuncture's Healing Touch
Safe Toys for Dogs
Separation Anxiety, Canine-Style
BONES & JOINTS
Hip Replacement Boosts Mobility at Any Age
Tips to Ease an Aching Back
Scientists ID New Genes Tied to Crohn's Disease
CANCER
Well Water Might Raise Bladder Cancer Risk
Selenium, Omega-3s May Stave Off Colorectal Cancer
No Verdict Yet on Grape Seed Extract vs. Breast Cancer
CAREGIVING
Birthmark or Blood Vessel Problem?
Injected Medication Errors a Major Problem
Preventing Shaken Baby Syndrome
CIRCULATORY SYSTEM
Migraines in Pregnancy Boost Vascular Risks
Bad Marriages Harder on Women's Health
Walk 100 Steps a Minute for 'Moderate' Exercise
COSMETIC
Science May Banish Bad Hair Days
New Genetic Links to Baldness Discovered
Get Sugared!.... Its a sweet choice for hair removal
DENTAL, ORAL
Study Links Osteoporosis Drugs to Jaw Trouble
Most Insured Adults Worry About Health Care Costs: Poll
Gum Disease Treatment Doesn't Cut Preterm Birth Risk
DIABETES
Fructose-Sweetened Drinks Up Metabolic Syndrome Risk
Whole Grains Take a Bite Out of Type 2 Diabetes Risk
Abnormal Heart Rhythm Boosts Death Risk for Diabetics
DIET, NUTRITION
Coffee Beans May Be Newest Stress-Buster
Potassium-Rich Foods May Cut Stroke, Heart Disease Risk
Vitamin D May Help Keep Aging at Bay
DISABILITIES
Could Your Cell Phone Help Shield You From Alzheimer's?
Review Finds Marijuana May Help MS Patients
ENVIRONMENTAL HEALTH
Household Insecticides May Be Linked to Autoimmune Diseases
Exhaust From Railroad Diesel Linked to Lung Ailments
Is It Safe to Go in the Gulf Coast's Water?
EYE CARE, VISION
Sports Eye Injuries Leading Cause of Blindness in Youths
Contact Lens Cases Often Contaminated
Time Teaches Brain to Recognize Objects
FITNESS
Will the Wii Keep You Fit?
Study Shows Exercise Shields Against Osteoporosis
After a Stroke, Light Exercise Gets Hands, Arms Working Again
GASTROINTESTINAL PROBLEMS
Intestinal Bacteria Trigger Immune Response
Olive Oil May Protect Against Bowel Disease
HRT Use Raises Risk of Stomach Trouble
GENERAL HEALTH
Any Old Cane Won't Do
U.S. Spends Billions On Alternative Medicine
Whole Grains, Bran May Fight Hypertension in Men
HEAD & NECK
Many Children Will Outgrow Headaches
Ski Helmets Encouraged for All
Zen May Thicken Brain, Thwart Pain
HEALTH & TECHNOLOGY
The Internet Is Becoming One-Stop Shopping for Health Help
Subway Defibrillators Save Lives
Study Suggests Link Between Cell Phones and Brain Tumors
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
Coffee Is Generally Heart-Friendly
Cocoa in Chocolate May Be Good for the Heart
Polyunsaturated Fats Really May Lower Heart Risk
INFECTIOUS DISEASE
Swine Flu Now Reported in All 50 States
Bacterial Infections May Succumb to Honey
Grapefruit Compound Inhibits Hepatitis C Virus
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Don't Leave Your Kids In The Car !
When It Comes to Toys, Shop Smart, Shop Safe
Plastics Chemical Tied to Aggression in Young Girls
MEN'S HEALTH
Soy Linked to Low Sperm Count
Sunlight May Help Protect Men From Kidney Cancer
Low Iron Levels Cut Cancer Risk in Men With PAD
MENTAL HEALTH
Mind Exercise Might Help Stroke Patients
Shop 'Til You Drop: You May Feel Better
Living Alone Increases Odds of Developing Dementia
PAIN
Alleviating Rheumatoid Arthritis
'Cell Phone Elbow' -- A New Ill for the Wired Age
Tai Chi May Help Ease Fibromyalgia
PHYSICAL THERAPY
PREGNANCY
Sugary Colas Tied to Gestational Diabetes
Breast-Feeding May Protect a Woman's Heart
Expectant Mom's Exercise Keeps Newborn's Birth Weight Down
SENIORS
15-Point Test Gauges Alzheimer's Risk
Martial Arts Training May Save Seniors' Hips
Fitness Fades Fast After 45
SEXUAL HEALTH
SLEEP DISORDERS
Better Sleep, Grades Seem to Go Up
6 to 8 Hours of Shut-Eye Is Optimal for Health
Exercising Throat Muscles May Relieve Sleep Apnea
WOMEN'S HEALTH
Exercise Boosts Bone Density in Breast-Feeding Moms
Green Tea May Help Treat Uterine Fibroids
Acupuncture May Relieve Acid Indigestation In Pregnancy
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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