1. The Promise and Peril of Electronic Health Records Cari Weishaar Final Project 12/8/11

2. Health care costs are too high… Source: OECD 2009

3. …and quality metrics are not better than other countries…

4. “…IT must play a central role in the redesign of the health care system if a substantial improvement in health care quality is to be achieved in the next decade.” - Institute of Medicine, Crossing the Quality Chasm 2001

5. Benefits of EHRs Safety – Decision support tools can prevent adverse drug events caused by mistakes in prescribing Efficiency – Patient information is better tracked thereby preventing redundancy of tests and procedures Effectiveness – Automated reminders can make physicians and their patients more compliant with treatment plans and preventative care recommendations

6. EHRs are made of many silos… Electronic Medical Record Legal Record of Pt Encounter Practice Management System Appts Billing Decision Support Tools ePrescribing Labs and Procedures Patient Portal Encounter Summary Secure Emailing Lab Results …with only one interface.

7. EHR Interface

9. Interoperability Legal Record of Pt Encounter Appts Billing ePrescribing Labs and Procedures Encounter Summary Secure Emailing Lab Results

10. EHR Adoption Rates Among Physicians

11. Why aren’t adoption rates higher? Misaligned incentives Cost are incurred by the individual practices, benefits are diffuse EHRs are expensive to maintain Resistance to change Learning to use the system is time consuming Clinicians don’t want to be data managers! Uncertainty about the future Standards are still evolving Too many choices (83 CCHIT certified Ambulatory EHRs in 2011)

12. Appendix

13. HITECH Funds Incentive payments for meeting “meaningful use” ePrescribing Electronically exchange information Clinical quality measures Reduced Medicare/Medicaid reimbursement by 2015 providers who do not meet meaningful use Finding for education, training and research

14. Small practices are lagging