05 Oct Katrina's destruction likely to speed up electronic healthcare records adoption
Years of efforts to promote electronic healthcare records have led to some adoption of the technology but there’s been little sense of urgency toward that adoption.
Then Hurricane Katrina slammed into the Gulf Coast, destroying countless medical records as part of her path of destruction.
Katrina, and her followup Rita, may not only have changed the landscape of the Gulf region but, also, changed the focus of debate on electronic healthcare records. It is becoming more apparent to many in health fields that such records not only facilitate better healthcare, they also serve as a data security measure.
Among the reasons for a move in the healthcare sector toward maintaining electronic medical records, conventional purposes are often put forward such as portability and interoperability over the old-fashioned paper record keeping.
Electronic records carry various advantages over paper, as the hurricanes have demonstrated. While New Orleans patients’ paper records were destroyed in the flooding, some prescription drug data has remained online, now being tracked on http://www.KatrinaHealth.org. In addition to providing integration in an enterprise, off-site electronic records provide a backup for the patient just in case the physical medical practice is gone.
“Clearly, the capability of electronic systems to not be ruined by whatever the disaster might be are much, much better than paper,” said Michael Gorczynski, director of medical informatics at Aurora Healthcare in Milwaukee. “Paper is a very fragile medium that can be blown away, washed away, blown up contaminated with biological agents.”
Doyle proposes state funding
To some, the progress coming from the private sector has not been fast enough. Wisconsin Gov. Jim Doyle has made the advancement of electronic records a point of his Grow Wisconsin initiatives, and earlier this year proposed a $10 million grant for setting up a board to oversee and subsidize the development of health records.
“When you look at Katrina and medical records, if they had had electronic medical records, they would not have been lost,” said Stephanie Marquis, a spokesperson for the Wisconsin Department of Health and Family Services. “They’re definitely more secure, and that sort of network can definitely improve patient quality and safety.”
The measure, however, went down to defeat in the Joint Finance Committee on a 13-3 vote in May. According to state Rep. Scott Jensen, a former Speaker and currently a member of the committee, a major concern was with the balance of public and private efforts. If the private sector is moving toward electronic medical records by itself — and, according to Jensen, people in the healthcare industry told them subsidies and programs were unnecessary — then why should the state throw taxpayer dollars at it?
“I think the notion of taxpayer subsidies for electronic medical records was something of a fad last year, for politicians who were looking to say they’d done something for healthcare costs,” Jensen said.
State can leverage its buying power
Jensen did say, however, that the state can play a role within the market not by subsidizing ongoing innovations, but simply by leveraging its purchasing power for its own healthcare needs and making a point of dealing with providers that maintain electronic records.
According to Gorczynski, progress has already been made in Wisconsin by private companies. Aurora alone currently has records for about 3.5 million patients, ranging from people who came in for one emergency room visit up through those who use Aurora facilities and staff for their primary care.
While Gorczynski acknowledged some role for the state to play in financial aid and guidelines for the development of electronic records, he also said it’s not much of a role compared to the private sector and the federal government. He added, however, that the state has a more important part to play in necessary deregulation to speed up the process. He especially noted that Wisconsin’s privacy statutes dating back to over 25 years ago have had the unintended consequence of hindering some necessary data sharing.
“Those state laws that are getting in the way with privacy protection are really superseded by federal legislation in the form HIPAA, but HIPAA requires that we pay attention to these state laws as well,” Gorczynski explained. “So I think there’s an example where the state could help in clearing some of the legal barriers that we have to the adoption of electronic records.”
New federal law will be impetus
Among the federal initiatives is the Patient Safety and Quality Improvement Act, which President Bush signed this summer. While the act is intended to improve patient safety and the quality of healthcare, it’s side effect is expected to be an increased in the digitalization of healthcare records, says Don Woodlock, general manager of inpatient clinicals at GE Healthcare’s Information Technologies business in Waukesha, Wis.
“If you don’t have electronic healthcare records, it would be harder to handle the patient safety reporting,” Woodlock said.
GE Healthcare is active in the hospital side of electronic healthcare record keeping, which Woodlock says is expected to be a very big market. Less than a quarter of hospitals and physician groups now use electronic healthcare records, but that percentage should grow due to natural market forces and because of the impetus of the Patient Safety and Quality Improvement Act, he said.
In Wisconsin, many Democratic lawmakers maintain that electronic records should be helped further along through state aid.
‘Foolhardy’ to rely on paper
“What Katrina is doing, is it once again shows this dependency on paper records to be absolutely foolhardy for a nation as great as ours,” said state Rep. Sheldon Wasserman, D-Milwaukee, a medical doctor. “What Katrina shows is, of course, the underclass of society, but we also have an underclass that takes place in the medical system.”
Wasserman compared the idea of subsidies for electronic health records to accepted notions of grants, TIF districts and other means of government aiding economic development of certain geographic areas or business sectors. “We’re living in an information age, and it’s critical that government promote this.”
According to Marquis, the Doyle administration will continue to look into how it can further development of electronic records along, with or without specific legislative programs. “Right now we don’t know exactly what the governor will come up with for us, but he wants to keep this moving.”
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