A recent Washington Times editorial, "Federalizing medical records," noted that the electronic health record is “not a cure-all” or a “panacea” and that "establishing an integrated national health information system isn't as easy or as beneficial as it sounds."

 Did anyone in Washington, D.C., say EHRs were a cure-all? 

When President Obama released his budget in early May, David Blumenthal, MD, National Coordinator for Health Information Technology, said health IT was "a critical pillar" in Obama's blueprint to build more quality into American healthcare. In his July 23rd press conference, Obama said healthcare reform would involve the use of healthcare IT to "eliminate duplicate testing, prevent medical errors, help monitor chronic care, encourage preventive care and help doctors know what care is most effective." I don't think you'd find an EHR advocate who would say that EHRs are a cure-all or a panacea.

Did anyone say establishing a nationwide health information network would be easy? If anything, advocates have said it would be a very tough journey ahead but a necessary journey if people want whoever treats them regardless of where they are in this country to have a comprehensive view of their medical history in order to provide the most appropriate care for them.

The editorial goes on to say: "Despite the promise information technology holds for cutting down on unneeded procedures and helping avoid harmful drug interactions, it is far from a panacea." Whoever wrote the editorial (and the editorial board) needs to go to various health systems around the country to see that the promise of IT has already been delivered. Talk to the folks at UMass Memorial Health Care, Catholic Healthcare West, University of Pittsburgh Medical Center - just to name a few - who have documented their successes with health IT. They are also quick to add that it was not an easy road but it was the right thing to do for their patients.

It blasts efforts by the Departments of Defense and Veteran's Affairs for not being able to exchange health records. The two departments' inability to do so has been documented by the GAO, but the reasons for the lack of strategic planning have not been aired. One thing that can be said is that the two systems - AHLTA (Armed Forces Health Longitudinal Technology Application) and VistA (Veterans Health Information Systems and Technology Architecture) - work for their respective departments. The Federal Health Architecture has only been around for a couple of years, but the charter has created a number of successful interoperability initiatives among federal agencies and the private sector. One can look to these efforts to see that the federal government isn't a dinosaur in all endeavors.

The editorial stated: "Implementing computer record systems that work between doctors, hospitals and insurers has met with limited success. After decades of efforts, just 17 percent of U.S. physicians and 8 percent to 10 percent of hospitals have at least basic electronic health records systems, according to the New England Journal of Medicine." It doesn't talk about why there's a low adoption rate, as if that simply and conveniently isn't a part of the argument. The editorial concludes that "the private sector is working to accelerate the computerization of medical records because it can improve efficiency and performance." Why is the private sector working to accelerate EHRs now? One of the reasons for low adoption is upfront cost, which is why the federal stimulus package included incentives for providers to implement health IT. It's also a carrot for the private sector to build better systems that providers will use and find valuable. Otherwise known as "meaningful use."