Name: Insights: Electronic Health Records Created 'Not Solved' Problems (Part 1/4)
Uploaded: 2020-07-21
Duration: 5 min 49 s
Description: When the American healthcare system began to transition to Electronic Health Records, policy makers saw a future full of potential and possibility.

 SPEAKER 1: The story of the interoperable electronic health record starts in 1998. GEORGE W. BUSH: By computerizing health records, we can avoid dangerous medical mistakes, reduce costs-- BARACK OBAMA: We will make the immediate investments necessary to ensure that, within five years, all of America's medical records are computerized. JOE BIDEN: Further the use of technology in improving our health care system. JOHN ENSIGN: Electronic medical records just makes sense. [MUSIC PLAYING] BOB KOCHER: In the midst of the great recession, there was a giant opportunity to spend money in America to help us get out of that recession called the American Reinvestment and Recovery Act. And in that act, we had an opportunity for health care to have a section which offered doctors incentives to buy and then use alternate health records. FRED SCHULTE: Obama represented a new way of thinking on a lot of fronts, and one of them was technology. This was something that he saw as long overdue. That every other industry was computerized, and it was just outrageous and stupid that we have all these paper files sitting in file cabinets that are doing nobody any good. So what Obama did is he decided to put money behind it. BARACK OBAMA: The Economic Recovery Plan I'm proposing will help modernize our health care system. And that won't just save jobs, it will save lives. We will make sure that every doctor's office and hospital in this country is using cutting edge technology and electronic medical records so that we can cut red tape, prevent medical mistakes, and help save billions of dollars each year. RAJ RATWANI: And so in 2009, the federal government, Congress, passed what was called the HITECH Act. It stands for the Health Information Technology for Economic and Clinical Health Act. JON LOMURRO: The goal of HITECH was, by 2015, every single person in America would have an electronic health medical record that would be transferable. ILANA YURKIEWICZ: So the goal is to improve patient's safety and to create a system of easily accessible information that can be as useful as possible for providers to make safe and informed health care decisions for their patients. [MUSIC PLAYING] DAVID BLUMENTHAL: I'm pleased and excited to say that the registration process is now open for health care providers to obtain significant incentive payments for adoption and meaningful use of electronic health records. RAJ RATWANI: As part of the process of promoting electronic health records, a certification program was set up. And that certification program provided, essentially, rules by which technology needed to be developed in order for it to be tied to reimbursement payments by the federal government. ERIKA FRY: For doctors to get the federal payments for adopting electronic health records, they had to prove that they were using the electronic health records in a meaningful way. BOB KOCHER: If they bottom out their health record, on year one, show that they used it. In year two, used it to more effectively affect patient outcomes. And then in year three, to really be a more effective doctor. LAMAR ALEXANDER: To receive incentive payments, physicians and hospitals had to buy systems certified to federal government specifications. Providers assumed that the certified systems would be high quality and meet program requirements. BOB KOCHER: Well, we certainly thought when you provide $44 billion of incentive for people to buy software products, that the industry is going to grow a lot. And not surprisingly, there was a lot of growth in the industry after the HITECH Act was enacted. ROSS TEAGUE: The requirements that were there in terms of meaningful use. The time frames that were there. A lot of things got built that were built to check the box of meeting that and getting it out the door in time for people to be certified and meet that. And so, when things like that happen, when you rush-- when you rush, things can-- Unintended consequences can be one of the downstream effect of causing someone to do that. ERIKA FRY: So there was software that didn't work the way that the companies said it did. They had taken shortcuts in order to meet government requirements, and so there were actual software defects. FRED SCHULTE: There was tons of requirements and regulation, but I think that critics might say that they weren't the right regulations. I think that they needed to make sure that the products were, in fact, safe. And they needed to rapidly-- in the view of critics-- rapidly investigate any failures to make these systems better. ERIKA FRY: Poor EHR design and poor implementations of the systems have really led to some horrible cases of suffering, injury or death. [MUSIC PLAYING] LAMAR ALEXANDER: The hope was that the program would improve care, coordination and reduce costs. The evidence suggests these goals haven't been reached. A medical economic survey last year found nearly 70% of physicians say their electronic health record systems have not been worth it. One physician wrote, "we used to see 32 patients a day with one tech and now we struggle to see 24 patients a day with four techs," and we provide worse care. FRED SCHULTE: That nobody could dispute that putting all that money out there did, in fact, get people to install this equipment. But it wasn't just about installing computers in doctor's offices, it was about all these other things, like having interoperability, having ability to forage through vast amounts of data to find new treatments for disease. So there were all these other things, and those are the things that really haven't been accomplished. [MUSIC PLAYING] 

When the American healthcare system began to transition to Electronic Health Records, policy makers saw a future full of potential and possibility.

Insights: Electronic Health Records Created "Not Solved" Problems (Part 1/4)

Bob Kocher, Fred Schulte, Raj Ratwani, PHD., Jon Lomurro, Llana Yurkiewicz, MD, Erika Fry

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Policy makers saw the potential in American EHR's transition