Electronic Records Revolution About To Hit?

With all the talk about implementing electronic health records throughout California’s health care centers, you would think technology is now part of the health infrastructure. But adoption of EHRs by physicians and hospitals is far from ubiquitous in the state, according to Larry Dickey, medical director at the Office of Health Information Technology, in the state’s Department of Health Care Services.

The data are not good on just how many physicians have implemented EHRs so far, Dickey said, but it’s clear that a large number of private clinicians do not have them.

“The larger physician groups are more likely to have them than the solo practitioners,” Dickey said. Hospitals, “where you would expect much higher numbers,” Dickey said, are still lagging. Dickey said “45% of hospitals have no electronic health record at all.”

And of the 55% with electronic systems, many of those systems are only partially in place, he said.

Most people in medicine are aware of the promise of electronic systems, said panelist Anna-Lisa Silvestre, who is the vice president for online services at Kaiser Permanente.

“We all want to improve quality and improve cost, that’s what we are all hoping for,” Silvestre said. “It will take us outside of the four walls where care is delivered — to provide care at home, in the car, at school, at work.”

But getting harried physicians with busy practices to adopt the new technology can be a challenge.

“If you pay them, they will come,” Dickey said. “The question is, are you going to pay them enough?”

Dickey said he thinks what the federal government has offered as incentive will be enough, with bigger hospitals eligible for millions of dollars for electronic health record systems — if they meet certain “meaningful use” standards. “They need to adopt, install or upgrade, and use them in a meaningful manner,” he said.

The state of California does have a milestone in mind, Dickey said.

“We hope that 90% of providers by 2020 will be using EHRs,” he said. “That might be a little ambitious, but that’s the goal.”

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