Healthcare is badly in need of some cost-savings. A new study suggests that a change in the way we keep health records could save billions. Last week the industry got a look at a cost-benefit model for personal health records. According to the report, widespread use of PHRs could save the US healthcare industry between $13 and $21 billion a year.

The Center for Information Technology Leadership (CITL), a nonprofit IT research center based at Partners HealthCare System in Boston, offers the projections in the study “The Value of Personal Health Records.” The study describes an evidence-based model that estimates the industry costs and benefits of four different PHR architectures. The study is the first of its kind to examine the different PHR architectures and show their direct cost savings to healthcare providers and payers, CITL officials say. (more…)

“HIM and health IT are finding that the scope and responsibilities of individual job functions are increasingly crossing department domains,” write the authors of the practice brief “HIM and Health IT,” published in this month’s issue. They note a “universal need for alignment between the two disciplines to ensure that both business processes and technology are in place to advance successfully toward a fully functional [electronic health record].”

The brief explores that need for collaboration through three domains: confidentiality and security, data use and maintenance, and terminology asset management. Seven Web-only extras offer tools to help with that alignment. (more…)

In Illinois healthcare organizations and trial lawyers are disagreeing over how much facilities may charge when fulfilling requests for health records that are stored electronically. Also at issue is whether facilities must provide their digital records in a digital format.

A state law lowering the copy fees for electronic documents went into effect January 1, 2008. The law, the result of negotiations that tempered reductions in earlier proposed legislation, is already being countered with a bill to create a higher flat rate for all copying, regardless of record format.

In part, the tug-of-war highlights the gap between expectations over health IT’s potential and the current reality on the ground. (more…)

A practice brief in the October issue offers a great introduction to enterprise content and record management and its application in healthcare organizations. The online version offers five web-only extras that help organizations begin planning. (more…)

Project HealthDesign is a Robert Wood Johnson Foundation program to push the design of next-generation personal health records. Nine design teams received grants to develop forward-looking PHR prototypes that meet unique needs of different patient populations. The prototypes were demonstrated two weeks ago—RWJF has posted a webcast. (more…)

In the August magazine, Mark Leavitt, MD, PhD, describes how product certification reduces risk and effort in selecting electronic health record systems. Certification also plays a role in promoting financial incentives for physician practices that adopt EHRs.

Organizations offering incentives necessarily put eligibility requirements around EHR systems to ensure that participating systems can deliver baseline benefits in quality measurement and improvement. Certification from a recognized body offers them a “solid qualifying mechanism” to do that, Leavitt says. (more…)

In the August issue we published a selected bibliography of research and writing on EHRs in physician practices. This is the extended version, as promised in the print issue. (more…)

As EHRs take center stage in the healthcare movement, numerous surveys have attempted to determine their rate of use, affect on quality, and the barriers to their implementation. The results usually agree in general, but the exact numbers they produce can differ greatly. One reason is that even objective studies can be unscientific.

The Institute for Health Policy (IHP) wanted a definitive answer on how many physicians were using EHRs. They got their chance with a grant from the Office of the National Coordinator for Health Information Technology (ONC), which they used to produce the study “Electronic Health Records in Ambulatory Care—A National Survey of Physicians.” The survey, which appeared in the July 3, 2008, issue of the New England Journal of Medicine, aims to provide a scientific, accurate look at physician EHR use. (more…)

In a June print story on bad documentation practices in electronic health records, Stephen Levinson, MD, warns against poorly designed systems that encourage busy physicians to copy old information forward with a single click, speeding them past performing and documenting care.

Copying forward a previous review of systems without reviewing changes in the patient’s status, for example, is noncompliant and potentially fraudulent, Levinson says. Above all, it is poor care. “The tool has taken away what the doctor is supposed to do, which is to obtain information on the review of systems since the last visit,” he says.

Is there ever an appropriate use of copy forward?

Levinson says yes, with an important caveat. (more…)

Banking health data like a financial transaction is the simplest solution to healthcare’s networking challenges, says William Yasnoff, MD, PhD, founder of the Health Record Banking Alliance, in the May feature “Taking Medical Records to the Bank.”

So far no one has started a health record bank, though several states are considering or planning them. One question still to answer is how to finance their ongoing operation. There are several options, Yasnoff says. (more…)