Electronic Health Records for All

Panacea or pandemonium?

Article Highlights:
  • Electronic health records (EHRs) proposed for all U.S. citizens
  • More than $17 billion in "stimulus" monies to doctors and hospitals for EHR systems
  • EHRs have both supporters and detractors
  • Existing electronic medical records systems can't "talk" to each other
by Bill Norman on October 1, 2009 - 3:34pm

QUEST Vol. 16, No. 4

An ambitious proposal from the Obama Administration seeks to provide an electronic health record (EHR) for all Americans by 2014. It’s a proposal with far-reaching implications for anyone who receives professional health care, and it has both supporters and detractors.

The American Reinvestment and Recovery Act of 2009 (the “economic stimulus plan”) that became law in February contains a section called the Health Information Technology for Economic and Clinical Health Act, or HITECH Act. It makes available more than $17 billion in financial incentives for physicians and hospitals to adopt and use EHR.

The goal of HITECH is to both save costs and create a continuum of health care data for all patients representing a lifelong record, updated as needed by a wide range of people and organizations.

Although central to the health care debate, EHRs are neither well developed nor well understood.  An Arizona State University poll taken in June 2009 found that 15 percent of responders said they had heard “a lot” about EHRs; 49 percent had heard “some” or “only a little”; and 36 percent said they’d heard “nothing at all.”

Here then is Quest’s attempt to shed a little more light on the subject.



All but a few EHR systems now in use across the country are stand-alone systems. They may link multiple hospitals and physicians within a parent organization, but can’t communicate with systems of other care providers.

Cathy Lomen-Hoerth, director of the MDA/ALS clinic at UCSF Medical Center in San Francisco, said her clinic uses five different electronic records systems and “none of them can talk to each other.” She has one system for dictation with voice input, another for dictation entered on a keyboard, one for inpatient records, one for outpatient records (in old MS-DOS format) and one that is her personal database for use in the clinic.

Joe Hornyak, co-director of the MDA Clinic at the University of Michigan, said the clinic has had inpatient and outpatient records computerized for several years. “It really is a wonderful system to have access to UM providers’ notes at my fingertips … but it’s frustrating not having this access to outside providers’ records, as we are never quite sure what is going on.”

Katalin Scherer, MDA/ALS center director in Tucson, Ariz., said those who believe a nationwide EHR system is workable are “operating under a huge misconception.”  Scherer said her clinic, which is affiliated with University Physicians Healthcare, has had an in-house EHR system in place for three years.

“We use a system supplied by Allscripts, as do several other care provider networks in Tucson, but even though the software is the same, our systems can’t communicate with each other,” she said. “That’s partly due to government-mandated protections of patient data that are built into the software. They protect information, but they prevent communication.”



Read more online:

Your rating: None Average: 4 (1 vote)
MDA cannot respond to questions asked in the comments field. For help with questions, contact your local MDA office or clinic or email publications@mdausa.org. See comment policy