Happy Mother's Day to Ann Dunham

President Obama's desire to cut administrative costs, save forests from paper mills, and provide better coordinated health care by digitizing medical records makes sense. I wouldn't be surprised if, like the Patient Protection and Affordable Care Act, it arises from his mother's experience of the US health care system and private insurers. The satirical website Extormity was created to mirror the voluntary electronic health record system which preceded the 2009 HITECH act, and I'm sure they still find much material worthy of satirical treatment. 

Incentives, Disincentives, Best Results Thus Far

By law, there are now monetary incentives for innovating and implementing digital health care records. As part of the same law, there will soon be penalties for failing to use electronic health records in hospitals, clinics, and medical practices. To my knowledge, the best result of the HITECH law thus far has been the Care Connectivity Consortium, composed of millions of patients in all fifty states who are part of just five non-profit health systems. It is significant that their effort began before the monetary incentives were enacted, and all five systems were early adopters of electronic records. They have, for example, exceeded HITECH's implementation schedule for 2013, a digital list of a patient's medications. Since CCC is only slightly over one year old, it is too early to know more than anecdotal evidence about patient outcomes, good or bad. It is evident, however, that just system-wide availability of a patient's medications is a major method of preventing bad outcomes from drug interactions. 


Glossary
CCC - Care Connectivity Consortium
EHR - electronic health record
MHR - medical health record
PHR - personal health record
HIT - health information technology
HITECH - Health Information Technology for Economic and Clinical Health (2009 law)
CCHIT - Certification Commission for Health IT (voluntary industry predecessor to HITECH)