Making EHR meaningful

It’s no secret that our current healthcare system is a structure of “haves” and “have nots.” Racial and ethnic disparities in care have been well documented.

This is especially true in access and treatment for diseases such as breast cancer. There are many reasons for this – genetic, cultural, socio-economic, access, and beliefs about preventive care are just some of them.   I wrote a whole Master’s Thesis about cultural beliefs and breast cancer prevention.

Recently, I came across an article about this; it discussed a pilot program of patient registries in NYC hospitals and how they are helping to improve care. If an oncology appointment was missed, the practice was notified by a researcher;

“Among black and Hispanic women, statistically significant increases in completed oncology consultations as well as increases in use of radiotherapy, chemotherapy, and endocrine therapy were observed”.

Follow through. Care coordination. Being on top of things. Physicians say they don’t have the time or staff to track every patient. That’s where the use of Electronic Health Records (EHRs) can help. The Affordable Care Act even provides incentives for practices to “go paperless,” keep centralized databases that can track patients for them – and trigger alerts, auto-generated emails, or other processes to notify the physician or clinical staff that a screening is due, an appointment has been missed, or that the results of a test need additional follow up.

Two major challenges exist – cost, and useability. While larger health systems are already implementing this approach, the smaller/solo practices are being left in the dust. The time, money, and effort to make a paradigm change can be daunting. The administration has offered incentives to practices that do make the change over to electronic records.

Hospitals and larger practices are in the process of enacting a set of standardized protocols, called the EHR Adoption ModelSM(EMRAM). About 2/3 of hospitals have implemented some or most of this system, which is great news for for those working or being treated in a facility; that still doesn’t address the issue of small/solo practitioner adoption.

As a patient, you want records that are accurate, current, and accessible by providers and specialists no matter where you, or your doctor may be. And you don’t want to have to go through duplication of services or tests, be unsure about medication interactions, or have adverse events due to lack of information or (worse) poor physician handwriting.

Small practice physicians being left behind is a strong concern among some physician groups and industry experts. Only 15 percent of primary doctors currently use EHRs, according to Modern Medicine. Several medical associations want more flexible government rules on incentives to encourage more participation by small practices.

EHRs will make these practices more efficient, cost-effective, improve patient outcomes and safety. There’s no point in HHS talking about “meaningful use” of EHRs if so many physicians can’t afford to use them.