Electronic Health Systems: Good for Health, Sanity, and the Environment Too

| November 19, 2011 | 0 Comments

Shaira Bhanji
Global Health Finance Columnist

Photo courtesy of the University of Missouri News Bureau.

Paper records, the optimal means by which to capitalize on human error, characterize most current medical information systems. The results are incorrectly prescribed drugs, service delays, and lost files, which together eat about 30-50 percent of U.S. healthcare spending—a hefty $1 trillion per year.[1] Unbeknownst to many, medical errors surpass cancer and other deadly diseases as the number one leading cause of death in the U.S.[2] Furthermore, the implicit costs many patients face—having to go through a labyrinth of phone calls, red tape, and bureaucracy to get in touch with the person in charge of their health—make the medical system a hassle to deal with, and consequently something many people prefer to avoid.

In an era in which technology is so prevalent, holding on to obsolete record keeping methods is like trying to hold onto melting ice cubes. In other words, the process of storing paper medical records is a futile attempt at trying to keep a naturally messy room clean: only so much paper can fit into a patient’s flimsy file folder. After the folder is bursting at the seams, start another. When the patient isn’t being treated anymore, send their records to the maze of files known as the medical warehouse. When the warehouse gets full, fill up another one and hope to be able to find the files later.

Some companies, such as Kaiser Permanente, have recognized the many perks of going paperless by creating electronic health records (EHRs) via health information technology (HIT). Kaiser spent $4 billion to create an online system through Microsoft’s HealthVault mechanism that includes a portion called “My Health Manager,” through which patients can e-mail their doctors, refill prescriptions, and even view their lab results.[3],[4],[5],[6]

Critics may argue that this gives patients too much control, including the ability to pester doctors with every little question and worry unnecessarily about lab results they may not understand. However, many of the current inefficiencies in the system come from this very lack of accessibility and transparency that provokes moral hazard or overuse of the system as patients push to get the care they deserve.

Going electronic sounds sophisticated, but is the juice worth the squeeze? Since adoption, Kaiser has cut patient visits by 26 percent per patient on average.[7] Kaiser isn’t the only one; the Cleveland Clinic and the Beth Israel Deaconess Medical Center have also adopted this novel system.[8],[4]

One would be hard-pressed to find a concrete study that conclusively asserts that EHRs are cost-effective. However, a 2007 study presented in the Journal of the American College of Surgeons compares costs before and after the implementation of EHRs in five centers made of 28 providers and found savings of $10,000 per provider per year.[9]

The benefits of electronic systems are not limited to patients. A study published in May 2011 in Health Affairs estimates that Kaiser saves 1,044 tons of paper per year via its electronic system—no small amount given that healthcare contributes to 8 percent of the United States’ carbon emissions.[10]

Some may argue that costs for implementation are too high with the benefits not clearly defined. However, the current unsustainable system also has high costs which, when considering the lives that could be saved, are much more formidable. One thing is certain: now that electronic systems for managing health have been introduced, there is no going back. It’s time to renovate the messy room.


[1] Cutler, David M. “The Simple Economics of Health Reform.” The Economists’ Voice 7.5 (2010). Print.

[2] Kohn, Linda T., Janet M., Corrigan, and Molla S. Donaldson. To Err Is Human Building a Safer Health System. Washington: National Academy, 2000. Print.

[3] Ferguson, Jamie. Challenges And Learning In The New Era of Health IT. Rep. Kaiser Permanente, 2010. Print.

[4] McGee, Marianne K. “Microsoft, Kaiser Permanente Launch E-Health Record Pilot – Services – Hosted Applications.” InformationWeek | Business Technology News, Reviews and Blogs. 9 June 2008. Web. 31 Oct. 2011.

[5] McGee, Marianne K. “Microsoft Unveils Free Web Health Tools For Consumers.” Information Week, 4 Oct. 2007. Web. 30 Oct. 2011.

[6] Wulsin, Lucien, and Adam Dougherty. Health Information Technology-Electronic Health Records: A Primer. Rep. no. 08-013. California Research Bureau, 2008. Print.

[7] “HIT or Miss.” The Economist, 16 Apr. 2009. Web. 1 Nov. 2011.

[8] McGee, Marianne K., and Thomas Claburn. “Google, Cleveland Clinic Partner On Personal Health Record Service.” Information Week. 21 Feb. 2008. Web. 29 Oct. 2011.

[9] “Study: EHR System Efficiencies Can Cover the Cost of Adoption IHealthBeat.” IHealthBeat – Reporting Technology’s Impact on Health Care. California HealthCare Foundation/The Advisory Board Company, 13 July 2007. Web. 04 Nov. 2011.

[10] King, Rachel. “How Kaiser Permanente Went Paperless – BusinessWeek.” Bloomberg Business Week, 7 Apr. 2009. Web. 01 Nov. 2011.

Other related sources:

1. Berwick, D. M. “A User’s Manual For The IOM’s ‘Quality Chasm’ Report.” Health Affairs 21.3 (2002): 80-90. Print.

2. Buntin, M. B., M. F. Burke, M. C. Hoaglin, and D. Blumenthal. “The Benefits Of Health Information Technology: A Review Of The Recent Literature Shows Predominantly Positive Results.” Health Affairs 30.3 (2011): 464-71. Web. .

3. EHealth Strategies with Microsoft and Google in the Game. Rep. Impact Advisors, LLC, 30 Sept. 2008. Web.

4. Electronic Health Records Overview. Rep. McLean: National Institutes of Health, National Center for Research Resources, MITRE Center for Enterprise Modernization, 2006. Print.

5. Fields, Rachel. “Reaping the Benefits of Health IT: Q&A With ONC’s Dr. David Blumenthal.” Becker’s Hospital Review: Business & Legal Issues for Health System Leadership, 9 Mar. 2011. Web. 4 Nov. 2011.

6. IT News Staff. “Kaiser Study Finds EHRs Have Greening Effect.” Healthcare IT News/HIMSS, 4 May 2011. Web. 3 Nov. 2011.

7. Journal, Sacramento Business. “Kaiser Completes Outpatient Electronic Health Record System – Sacramento Business Journal.” Business News – The Business Journals. Sacramento Business Journal, 5 May 2008. Web. 4 Nov. 2011.

8. Microsoft HealthVault: Enabling New Approaches to Chronic Disease Management. Rep. Microsoft, Kaiser Permanente, and the American Heart Association, 2011. Print.

9. Ohsfeldt, R. L. “Implementation of Hospital Computerized Physician Order Entry Systems in a Rural State: Feasibility and Financial Impact.” Journal of the American Medical Informatics Association 12.1 (2004): 20-27. Print.

10. Oldenburg, Jan. Lessons Learned– Kaiser Permanente’s Implementation of My Health Manager. Rep. Kaiser Permanente, 2010. Print.

11. Weaver, Christopher. “Savings From Computerizing Medical Records Are Hard To Measure – Kaiser Health News.” Kaiser Health News. Henry J. Kaiser Family Foundation, 7 Apr. 2010. Web. 02 Nov. 2011.

12. Wiesenthal, MD, SM, Andrew M. Kaiser Permanente’s Journey and Ultimate Success with Health IT. Rep. Permanente Federation. Print.

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