By Toro520:
In preparation for the exceptionally unpopular and illegal implementation of ‘Obamacare,’ the Obama administration is quickly advancing the encactment of a controversial and heavily criticised centralised, systematic collection of electronic health information commonly referred to as Electronic Health Records (EHR) or Electronic Patient Records (EPR). It is a record in digital format that is capable of being shared across different health care settings, by being embedded in network-connected enterprise-wide information systems. Such records may include a whole range of data in comprehensive or summary form, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal stats like age and weight, and billing information. Its purpose can be understood as a complete record of patient encounters that allows the automation and streamlining of the workflow in health care settings and increases safety through immediate, evidence-based decision support, allowing for quality management.
Modeled on the British National Health Service (NHS), the Obama administration plans sink billions of taxpayer dollars into the implementation of the project, including an array of very orwellian-sounding Health Information Technology Extension Centers required to train medical workers and troubleshoot the inevitable beurocratic chaos that will ensue. The system will requires thousands of templates and standards for each and every practitioner, and thousands more for the various electronic systems they use.
Proponents tout the success of similar systems in alternate professional fields as theorhetical evidence that such technology transfer would also prove to benefit the medical industry – and in theory, it makes sense. Practice is another matter.
Proponents argue that in EHR databases will provide long-term cost savings, reducing material waste associated with physical medical records, and reducing wasted man-hours required to manually manage physical paperwork, reducing administrative costs, in turn, freeing time for direct patient care. I can only begin to imagine the ruckus medical worker’s unions will make when they find out their job has become obsolete.
Furthermore, EHR could potentially improve care by supposedly reducing system errors by synchronizing immediate access to a patient’s medical history, allowing future care to be based upon a progressive evidence-based care. However, this assumes that user input will somehow become more accurate – after all, the program is still a product of, and susceptible to, manual human inputs; an ambivalent, objective tool, neither good, nor bad, but most definitely predisposed to corruption, whether it be an inncoent mistake or intentional manipulation.
Critics point out that while EHRs may save the “health system” money, physicians, those who buy the systems, may not benefit financially. Current private software packages cost between a few hundred to a few thousand dollars. However, the upfront cost for the national system proposed by the Obama administration is estimated to be tens of thousands of dollars once all factors are considered.
Firstly, each practitioner will be required purchase a license per computer per end-user, which must be renewed each year. Secondly, the practitioners will be required to experience significant down time in order to hire HITEC technicians to properly train administrative staff to use the new system, provide troubleshooting support in cases of error, and continuing education for users as the software evolves and changes. In a project initiated by the Office of the National Coordinator for Health Information (ONC), surveyors found that hospital administrators and physicians who had adopted EHR noted that any gains in efficiency were offset by reduced productivity as the technology was implemented, as well as the need to increase information technology staff to maintain the system. The U.S. Congressional Budget Office concluded that the cost savings may occur only in large integrated institutions, and not in small physician offices, concluding that “office-based physicians in particular may see no benefit if they purchase such a product—and may even suffer financial harm.”
Perhaps financial sabotage of small, private health care facilities is the legitimate means to an end.
Most doctors believe that adopting a system with EHRs would reduce clinical productivity and become an economic burden.
The HITECH Act, part of the 2009 economic stimulus package (ARRA) passed by the US Congress, only allows for minimum reimbursement of investments in EHRs, while simultaneously implementing mandatory fines for any and all physicians who refuse to participate: 1% of Medicare payments in the first year, increasing to 3% in 3 years.
A US representative enviously praised the NHS as “one of the truly astounding human endeavours of modern times”, but neglected to mention the failed efforts to put it into action. At the cost of billions of pounds in research and development, the NHS EHR system was origianlly scheduled for implementation in 2006 – delays have pushed back activation until 2015, by which they systme is expected to be uterrly obsolete.
“Depressingly, outside the world of the carefully-controlled trial, between 50% and 80% of electronic health record projects fail – and the larger the project, the more likely it is to fail. […] Our results provide no simple solutions to the problem of failed electronic patient records projects, nor do they support an anti-technology policy of returning to paper. Rather, they suggest it is time for researchers and policymakers to move beyond simplistic, technology-push models and consider how to capture the messiness and unpredictability of the real world.”
- Trisha Greenhalgh, Professor of Primary Health Care, University of London
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