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March 26, 2009
Here's something I'd like explained, now that I've read amazing findings in this week's New England Journal of Medicine about the pathetic pace at which health information technology, or health IT, is being adopted by hospitals, following a similar NEJM report last summer about foot-dragging physicians: Why are the benefits of health IT and electronic health records, and the fixability of their flaws, apparently taken for granted? More specifically, is it truly worth $30 billion, as the Obama administration proposes, to digitize everybody's individual medical histories, test results, medications, scans, clinical notes from physicians and nurses, and other healthcare detritus and convert them into electronic health records, accessible from anywhere? To enter prescriptions into hospital computers in order to slash the awful toll of patients injured or dead because of the wrong medication, the wrong dose, or a deadly drug interaction?
The new NEJM study found that 1.5 percent of hospitals have equipped all of their major medical services with comprehensive electronic health records. Add 7.6 percent for hospitals with EHRs in as few as one clinical unit. Computerized physician order entry (CPOE) of prescriptions is in use at 17 percent of hospitals. "Abysmally low," said Ashish Jha of the Harvard School of Public Health, the report's lead author, at a press conference on Tuesday. The main reasons identified by the thousands of hospitals that responded to a massive survey: not enough money to buy the systems ($20 million to $100 million), not enough money to maintain them, physician resistance, and unclear return on their investment.