Electronic Health Records: The Way Forward

Mike O'Brien

The transition from paper to electronic health records (EHR) has been one of the key projects this year at the national and local level.

As a natural progression in the digital age, the ultimate goal is to increase efficiency and drive down costs.

But the switch has been anything but smooth sailing with some healthcare providers complaining that they did not like their new system.

Even the DoD and VA have been accused by some of dragging their feet on the issue.


Mark Jones, the Senior Sales Director of the Healthcare division of IT management software and solutions company CA Technologies, offers an expert analysis of the challenges faced by the DoD/VA and other large organizations in their EHR integration efforts.

He told IDGA.org: "The technology challenge is providing the framework for real time computable data exchange of health information. While AHLTA and VistA overlap in many functional areas the systems are difficult to make interoperable as illustrated in some of the challenges uncovered at the Federal Health Care Center in North Chicago.

"Another challenge in integrating electronic health records is the sheer number of applications under the EHR umbrella that need to be modernized and adapted for data transfer.

"When dealing with PII it is always necessary to take every effort possible to protect the confidentiality, security and availability of the data while not making the interface so cumbersome as to interfere with treatment."

Related: [Podcast] Electronic Health Records for the DoD

He added that there is also the more fundamental challenge of harmonizing two separate cultures that approach operations and the development of IT in a different manner.

In May, Defense SecretaryChuck Hagel directed the Pentagon to seek new healthcare management software that would better integrate military health care records with the Department of Veterans Affairs.

The inability of the Department of Defense and the VA to develop a single, integrated electronic health record has been the source of much frustration on Capitol Hill. In February, the departments announced they were abandoning efforts to create a single system.

A bipartisan group of House representatives sent a letter to President Obama urging him to intervene and "end the back and forth" between the two departments.

The letter, which was signed by 20 representatives, urged the President to "Select a system, pick a path, and move forward."

Mr. Hagel, in a statement at the time, said: "Our service members and veterans, and their families, expect and deserve a seamless system to administer the benefits they have earned."

So what benefits can be expected once the system is fully in place?

Mr. Jones said: "Achieving full integration will result in better care through a single view into a patient’s record from the time they enlist to the time they are discharged.

"This holistic view would enable quicker diagnosis and better treatment of each veteran as there would be no lag time in trying to locate legacy records and information."

He characterizes the present state of EHR integration on a national level as being in its infancy, given that there is no single electronic health record but a myriad of EHR’s with corresponding proprietary attributes.

Mr. Jones said: "Through the HITECH Act and Meaningful Use incentives integration efforts are sure to accelerate and improve care for all parties."

Chris Dixon is the Senior Manager, State & Local Industry Analysis, at Deltek, the leading global provider of enterprise software and information solutions.

He said a recent study in the Medicare & Medicare Research Review predicts that 80-90% of primary care physicians in larger practices will have achieved meaningful use of EHRs by around 2018.

Mr. Dixon told IDGA.org: "Physicians in smaller practices and specialists will lag behind this rate of adoption — most likely in the 75-80% range by 2018. My guess is that public hospitals will lag slightly behind comparably large private providers. Community health centers will lag their similarly sized peers.

Related: Study Finds EHR Help Fight Vaccine Preventable Diseases

"This will be due mostly to the added layers of public-sector bureaucratic oversight and the need to accommodate the record-keeping needs for a patient population that is more transient and economically challenged than that served elsewhere. They will have the most significant need for robust record sharing and accuracy via regional and national exchanges."

Many of the issues raised in this article will be discussed at IDGA’s DoD/VA EHR Integration and Interoperability event next month. For full details, go to www.ElectronicHealthRecordsSummit.com