Advocates: U.S. Needs to Push Harder for E-Health

IDG News Service (Washington, D.C., Bureau) — The U.S. government needs to step up its push for electronic health records because they are not being adopted quickly enough, a group of health advocates said Friday.

Health-care providers in the United States continue to make errors that hurt tens of thousands of patients each year, and e-health records could prevent many of those problems, said Dr. Alan Lotvin, senior vice president of oncology for Magellan Health Services. The U.S. health-care system is failing patients "despite the fact we have the knowledge and the technology to really do a much, much better job."

About 3.5 percent of all U.S. hospital stays have a drug error associated with them, leading to more than 100,000 significant medical problems and nearly 30,000 deaths each year, said Lotvin, speaking at an e-health forum sponsored by the Information Technology and Innovation Foundation (ITIF) and the Health IT Now Coalition.

U.S. residents should have a "sense of outrage" when confronted with these prescription errors, which would largely be prevented with e-health records, Lotvin said. He compared the U.S. health-care system's record to Amazon.com, which received 2,000 orders per minute during the 2005 holiday shopping season.

"I use Amazon a lot -- I have never gotten the wrong book," he said. "We can't seem to get the pills from the pharmacy in the basement to Mrs. Smith in room 631 correctly. This is not acceptable."

Lotvin called on the U.S. Congress to pass legislation that would mandate that health-care providers report their error rates. He also called for a law that would require health-care providers that have made mistakes on a patient to pay for any subsequent care required. Many medical errors can result in long hospital stays or expensive procedures, and in many cases, patients or their insurance providers pay, he said.

"You break it, you fix it," he said. "That's a very simple concept. It's been around in china shops for years."

In addition, the ITIF, in a report released Friday, recommended several steps Congress could take to encourage the adoption of e-health records:

• Congress should pass legislation that supports the adoption of national health data standards. The report mentioned two bills that provide funding and organization at a national level, the Wired for Health Care Quality Act in the Senate, and the Promoting Health Information Technology Act in the House of Representatives.



• Congress should pass a bill to support the creation of health record data banks, data centers where individual patients could store and control their health data. The Independent Health Record Trust Act in the House would regulate data bank operators, prohibiting them from charging fees to health-care providers for accessing or updating an e-health record upon permission of the patient.



• The U.S. government should lead by example by covering the monthly access fees at health record data banks for patients covered by government-funded programs such as Medicare and the State Children's Health Insurance Program (SCHIP).



• Congress should allow patients free access to e-health records held by health-care providers. Currently, medical privacy laws allow patients to get paper copies of their medical records, but health-care providers can charge fees for copying and mailing those records. Congress should phase out those fees, a measure that would encourage doctors to move to electronic records, ITIF said.

Currently, only about 25 percent of U.S. doctors use e-health records, and only about 10 percent of them have e-health records fully integrated into their practices, ITIF said. But in Sweden, 90 percent of doctors use e-health records, and in Denmark, 88 percent do, according to the ITIF.

That shows that adoption in the U.S. is a matter of the right policies and incentives, said Robert Atkinson, ITIF's president. "This is not rocket science," he said.

More people need to push Congress to create incentives for e-health records, added Nancy Johnson, a former U.S. representative and co-chairwoman of the Health IT Now Coalition.

"Why, when we know this would help so much, are we not doing it?" Johnson said. "We know how to deliver a higher quality of care, and we're not doing it."