Tag: "electronic medical records"

Can EMRs Do More Harm than Good?

Apparently yes, according to this New York Times report:

Poorly designed, hard-to-use computerized health records are a threat to patient safety, and an independent agency should be set up to investigate injuries and deaths linked to health information technology, according to a federal study released Tuesday. The report by the Institute of Medicine comes as the government is spending billions of dollars in incentive payments to encourage doctors and hospitals to adopt electronic health records.

The Institute of Medicine committee also called for tracking the safety performance of electronic health records in use. Results from studies done so far, the report said, are mixed. Success stories are offset by reports of patients harmed. The advisory group recommended that electronic health record suppliers drop “hold harmless” clauses from their sales contracts. Such language often limits the freedom of doctors and hospitals to publicly raise questions about software errors or defects.

Nov 18, 2011 | 7 comments | by

Government to Add 122,000 Additional Medical Billing Codes

Medicare has about 7,500 different tasks for which physicians can get reimbursed. If you add in regional adjustments, there are potentially 6 billion different prices. If this isn’t complicated enough, doctors and hospital currently have about 18,000 different billing codes they can use when sending bills to insurers. However, the federal government doesn’t believe 18,000 codes allows for enough detail. According to the Wall Street Journal:

A new federally mandated version will expand the number to around 140,000—adding codes that describe precisely what bone was broken, or which artery is receiving a stent.

It will also have a code for recording that a patient’s injury occurred in a chicken coop. (See code.)

Indeed, health plans may never again wonder where a patient got hurt. There are codes for injuries in opera houses (see code), art galleries (see code), squash courts (see code) and nine locations in and around a mobile home (see codes), from the bathroom to the bedroom.

The level of detail is astounding. For example, there are three different codes for getting bitten by a squirrel. See for yourself.

Sep 15, 2011 | 7 comments | by

Ever Wonder Why Health Care is so Much Cheaper Outside the Country?

This is Kevin Outterson at The Incidental Economist:

In October 2013, the US health care system will undergo a dramatic coding change as we transition from ICD-9 to ICD-10….

[H]ospital inpatient procedural codes will grow from 3,800 to 72,000; physician diagnostic codes from 14,000 to 69,000. Implementation costs for a three physician practice may average $83,000, with the per-doctor implementation cost dropping to $28,500 in a ten doctor practice. (see Harris Meyer’s reporting in May 2011 Health Affairs). No one reimburses providers for these transition costs.

Aug 15, 2011 | 6 comments | by

Health IT Spending Is Not Working in Britain

The National Programme for IT in the National Health Service was launched in 2002 with a 2010 goal of providing every NHS patient with his very own electronic medical record. Yet in its most recent report, the British National Audit Office states that the Department of Health there has been a:

steady reduction in value delivered not matched by a reduction in costs. On this basis we conclude that the £2.7 billion spent on care records systems so far does not represent value for money, and we do not find grounds for confidence that the remaining planned spend of £4.3 billion will be different.

As in the U.S., the system was sold with claims that it would improve services and the quality of care. In fact, many of the proposed applications, like internet appointment scheduling, electronic prescribing, computerized order entry in hospitals, and a secure organizational broadband communications network are already in use, without government subsidy, in the U.S.

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Jul 20, 2011 | 8 comments | by

An EMR Update, a High-Risk Pool, and a Maze

EMR Update:  Just 1,026 registered hospitals and physicians out of a possible 56,599 have shown they use electronic records and other digital technology to meet federal “meaningful use” standards.

Maine’s high risk pool has only 14 people in it. HT to Yglesias

Dodd-Frank regulation maze. (neat graphic) (HT to David Henderson)

Jun 28, 2011 | 5 comments | by

Electronic Medical Records: Should the SEC Track the Brokerage Accounts of Hospital Clerks?

Study after study suggests that mandatory electronic medical records will raise health care costs without generating significant benefits. Despite this, ObamaCare requires that individual health information be posted to insecure databases in order to facilitate widespread access to extensive detail about every individual’s health. When the person involved is an important figure in a publicly traded company, public disclosure of previously private health information can move markets. Access to that information in advance of a public announcement can create tidy trading profits.

To see how much money even relatively unsophisticated insider trading schemes can create, consider the case of Cheng Yi Liang, an FDA chemist recently arrested for insider trading on FDA drug approval information. Mr. Liang had access to DARRTS, a confidential FDA database that manages, tracks, and reports on the progress of new drug applications. The FDA usually delays the public announcement of its decision for 24 hours after it informs a new drug applicant of its decision.

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Apr 12, 2011 | 6 comments | by

Why Electronic Medical Records Aren’t Being Used

About 20 percent of U.S. hospitals and 30 percent of office-based primary-care doctors — about 46,000 practitioners — had adopted a basic electronic record in 2010, according to government statistics. So why is that?

Such systems are hard to use and difficult to maintain. They disrupt clinical practice. They don’t increase efficiency and often don’t pay for themselves. They disrupt the doctor-patient interaction. And they are very, very expensive.

I fear that the current incentives — simple monetary carrots and sticks — that the government is trying in order to increase the use of information technology in the practice of medicine won’t work. Just as we have a patchwork insurance system in the US, we have a patchwork IT system as well. There are relatively few standards, tons of companies, and lots of failures. It costs too much, it doesn’t work as well as you’d think, and there are way too many avoidable errors.

This is by Aaron Carroll, an advocate of EMRs.

Mar 22, 2011 | 12 comments | by

Making EMRs Work

Scribes are finding their place in emergency rooms—having concluded that entering the data into an electronic medical record can often “take as much or more time than dealing with a patient,” a St. Louis area hospital has hired scribes, at $8 to $10 an hour, to record patient responses to physician questions. A physician interviewed in the article reports that this is a winning strategy because he can “spend more cognitive time on my patient rather than finding what box to enter this information in.”

Mar 03, 2011 | 11 comments | by

Bad News on E-Health: There’s No Payoff

Sheikh and his colleagues scrutinized 53 reviews of the evidence surrounding technologies including electronic medical records, computerized provider order entry and computerized decision-support systems. The strength of the evidence varied from technology to technology, but in general the review found that “many of the clinical claims made about the most commonly deployed [digital health] technologies cannot be substantiated by the empirical evidence,” the authors write.

Full article on the downside of computerized ordering systems.

Feb 09, 2011 | 7 comments | by

What Patients Think About Electronic Medical Records

A new survey suggests patients are less than forthcoming if they believe their medical records are being shared with outsiders. About 15 percent said they would conceal information from their doctor, while one-third would consider withholding information. What do patients have to hide? Information on their exercise habits (13%), eating habits (9%), smoking (7%), drinking (7%), illegal drug use (4%) and unprotected sex (4%) were the main items respondents would conceal.

Apr 23, 2010 | 18 comments | by
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