Universal Electronic Health Records: Progress or Boondoggle?

Implementing electronic health records (EHRs) for all 633,000 physicians and 5708 hospitals in the United States is a daunting task, and one that is being nudged forward by Team Obama’s $19 billion stimulus plan earmarked to help health care providers to switch to EHRs. But a March New England Journal of Medicine study by Jonathan Oberlander, PhD, and John Halamka, MD, MS, showed that only 1.5% of hospital records are fully computerized, and only 7.6% of hospitals have a basic EHR system. The low numbers reflect skepticism among physicians, health care administrators, and IT professionals about the feasibility and costs of widespread implementation of computerized patient records that are accessible, with privacy safeguards, throughout the medical system. ENT Today’s reports from the field reflect a mixed and interesting picture of EHR adoption thus far, and what the future may hold.

Experienced Otolaryngologists

Jeffrey LeBenger, MD, a board-certified otolaryngologist and Chairman of the Board of Summit Medical Group (SMG) of Berkeley Heights, NJ, has been instrumental in a three-year modular EHR implementation. SMG is a multispecialty group of 140 providers that has 1200 daily patient visits in its main 250,000-square-foot facility and five satellite offices. The EHR cost us a fortune and added a burden on our overhead structure, but it has been worth it, said Dr. LeBenger.

Starting in 2004, SMG’s EHR effort involved countless hours of physician, IT, and administrative work vetting vendors and writing a strategic IT plan. Once we settled on a system, we started the EHR with patient charts and notes. With lots of physicians, it’s like herding cats, and there were differences between young, tech-savvy doctors and the old-timers with 25 years of paper charting. We finally got everyone to the point where all notes were on the EHR, Dr. LeBenger explained.

With an IT department of 25, SMG scanned and archived-in a 100,000-square-foot storage facility-all patient charts dating from 1998, including notes, test and lab results, and surgery and consult reports. The EHR is also interoperable with Atlantic Health’s Morristown Medical Hospital, an essential and innovative collaboration that has, according to Dr. LeBenger, increased efficiency by 20% and facilitated the flow of all lab results, radiology, imaging, audiology, rehab notes, and other information.

SMG’s most recent addition to its EHR has been automating prescriptions, which go to the on-site pharmacy and can be picked up on the patient’s way out. It saves us time, reduces errors, is automatic, searches for drug-drug interactions and the patients love it, Dr LeBenger added. When asked about the government’s plan for widespread EHR implementation, Dr. LeBenger summed up: They have no clue how expensive and time-consuming this is for medical groups. It can easily cost in the millions for a group.