A prescription for electronic health records: converting paper files into electronic health records (EHRs) can lower costs, reduce medical errors, and save lives, but the development expenses and technological challenges are great.

• Author: Swartz, Nikki
• Position: The Use & Misuse of Information

Imagine sitting down at a computer and being able to access, download, and print your medical records. If you move across the country, you will still be able to access your and your Family's medical records online, as will your new doctors, hospital, pharmacy, and insurance company.

In many nations around the world today, this is now or soon will be reality for patients. But the United States is just beginning to explore the possibilities of making electronic health records (EHRs) accessible to patients, doctors, and hospitals from anywhere, which experts say could significantly improve the quality of care, better protect patient records, and reduce harmful medical errors.

Countless studies have shown that the archaic information systems of U.S. hospitals and clinics directly affect the quality of care patients receive. When a patient visits a new hospital or clinic, it most likely will have little information about him or her and no way to track how other providers have treated him or her in the past.

According to The Journal of the American Medical Association, each year, as many as 98,000 patients die in U.S. hospitals from preventable medical errors, such as receiving the wrong medication. Nearly half of all patients do not get all the treatments or tests that they should have received. These problems persist because of industry-wide failures connected to the lack of reliable health information.

If U.S. patients' health records were connected in secure computer networks that safeguard privacy, healthcare providers would have complete records for patients and, thus, be able to more accurately treat them. New information systems also would provide nationwide data to develop standardized performance measurements, so patients could go online and get accurate information about how good a job their doctors or hospitals do.

According to research firm Harris Interactive, the major causes of medical errors include multiple physicians treating the same patient without all having access to all the patient's medical records and with each storing different, incomplete medical records in different places. There is near consensus among healthcare industry experts that the widespread use of EHRs, accessible to all those seeing and treating a patient as well as to the patient, would substantially improve the coordination and quality of health care. In addition, electronic prescribing would further reduce errors that result from handwritten, hard-to-decipher prescriptions.

Bush Announces EHR Initiative

In April, President Bush unveiled a plan to implement EHRs for every American within 10 years. In calling for the widespread adoption of EHRs, Bush said, "[t]he 21st-century healthcare system is using a 19th-century paperwork system." He said paper records contain too many errors and inefficiencies, and they hinder communication between healthcare providers.

Bush has appointed a new Department of Health and Human Services (HHS) official dedicated to digitizing the U.S. healthcare industry. The national health information technology coordinator is responsible for developing, maintaining, and directing "the implementation of a strategic plan to guide the nationwide implementation of interoperable health information technology in both the public and private healthcare sectors that will reduce medical errors, improve quality, and produce greater value for healthcare expenditures."

According to Bush's executive order, "the work of the National Coordinator must be consistent with a vision of developing a nationwide interoperable health information technology infrastructure that

* ensures appropriate information to guide medical decisions is available at the time and place of care

* improves healthcare quality, reduces medical errors, and advances the delivery of appropriate, evidence-based medical care

* reduces healthcare costs resulting from inefficiency, medical errors, inappropriate care, and incomplete information

* promotes a more effective marketplace, greater competition, and increased choice through the wider availability of accurate information on healthcare costs, quality, and outcomes

* improves the coordination of care and information among hospitals, laboratories, physician offices, and other ambulatory care providers through an effective infrastructure for the secure and authorized exchange of healthcare information

* ensures that patients' individually identifiable health information is secured and protected"

At an HHS-sponsored information technology summit held in May, HHS...