Providence Journals - Editorial: Expensive Record Systems
17/01/09 16:27
All of this will matter to the incoming president. Barack Obama campaigned on a reform plan that included substantial investments in electronic-record keeping. But the financial crisis, on top of the experience to date with such systems, has some experts proposing a slowdown.
Last month, in an open letter to Mr. Obama, David C. Kibbe and Brian Klepper wrote that it would be a mistake, right now, to invest heavily in electronic record keeping systems. They said they are “notoriously expensive,” as much as $40,000 per doctor in a medium-sized practice. Yet a secure, nationwide system for storing the information still does not exist. And the systems available have trouble talking to each other. (Mr. Kibbe is a senior technology adviser to the American Academy of Family Physicians; Mr. Klepper analyzes the health-care market.)
Additional privacy questions bedevil the switch. States’ privacy laws conflict, making information sharing more complicated. And people who sign up will have all their records available, including some they might not wish everyone to see.
The New England Journal of Medicine recently noted that only 13 percent of doctors have thus far computerized their records. Most are in large practices. For others, the cost looks prohibitive as well as unjustified. Most of the savings, if any, fall to insurers or the government. (It is nice when people stay healthy, but doctors are not paid when they do.)
Rather than spend billions to pull the remaining records into so-so systems, the Obama administration would do well to invest in improving the technology. After that, offering low-interest loans to help doctors convert might make some sense.
Such second thoughts leave Rhode Island in a peculiar position. An ambitious statewide effort, the Health Information Exchange, is set to go, with the goal of connecting all health-care consumers electronically in five years. The Rhode Island Quality Institute, which is handling the effort, has $5 million in federal money and plans to begin limited, voluntary enrollment in March.
Participants may choose who will have access (just emergency physicians, for instance, or certain providers). But they cannot dictate what their records contain, which could inspire qualms. Increasingly frequent data breaches in the financial realm might add to those qualms.
Improving health care is one of the most urgent problems facing Mr. Obama. But, given the country’s poor financial health, we hope he will invest in the most promising reforms first. It might be too soon to throw billions of dollars at electronic record keeping.
Last month, in an open letter to Mr. Obama, David C. Kibbe and Brian Klepper wrote that it would be a mistake, right now, to invest heavily in electronic record keeping systems. They said they are “notoriously expensive,” as much as $40,000 per doctor in a medium-sized practice. Yet a secure, nationwide system for storing the information still does not exist. And the systems available have trouble talking to each other. (Mr. Kibbe is a senior technology adviser to the American Academy of Family Physicians; Mr. Klepper analyzes the health-care market.)
Additional privacy questions bedevil the switch. States’ privacy laws conflict, making information sharing more complicated. And people who sign up will have all their records available, including some they might not wish everyone to see.
The New England Journal of Medicine recently noted that only 13 percent of doctors have thus far computerized their records. Most are in large practices. For others, the cost looks prohibitive as well as unjustified. Most of the savings, if any, fall to insurers or the government. (It is nice when people stay healthy, but doctors are not paid when they do.)
Rather than spend billions to pull the remaining records into so-so systems, the Obama administration would do well to invest in improving the technology. After that, offering low-interest loans to help doctors convert might make some sense.
Such second thoughts leave Rhode Island in a peculiar position. An ambitious statewide effort, the Health Information Exchange, is set to go, with the goal of connecting all health-care consumers electronically in five years. The Rhode Island Quality Institute, which is handling the effort, has $5 million in federal money and plans to begin limited, voluntary enrollment in March.
Participants may choose who will have access (just emergency physicians, for instance, or certain providers). But they cannot dictate what their records contain, which could inspire qualms. Increasingly frequent data breaches in the financial realm might add to those qualms.
Improving health care is one of the most urgent problems facing Mr. Obama. But, given the country’s poor financial health, we hope he will invest in the most promising reforms first. It might be too soon to throw billions of dollars at electronic record keeping.