In the wake of the Hurricane Katrina crisis, untold numbers of medical records may have been lost. Many evacuees forgot or misplaced their medications, and some do not remember the names of all their medications. With no access to previous medical records, the evacuees' doctors have no way of confirming medications, immunizations, test results, and other past history. The storm has led to increased demands for electronic hospital records.
In the event of another natural disaster or a large-scale terrorist attack, electronic medical records (EMRs) could allow health care professionals to access patients’ histories and avoid compromising patient safety. Many hope that in the future EMR systems will be used to create a nationwide network that allows quick access to the medical history of a patient, paperless prescriptions that may cut drug errors, and other features that would increase patient safety and clinical effectiveness.
While EMRs have the potential to improve patient care and save billions of dollars in health care costs, surprisingly few physicians have invested in the technology. According to a September 2005 report by the RAND Corporation, the delay is due to the initial cost of adopting computer systems. RAND estimates that $81 billion a year could be saved-$77 billion from improved efficiency and $4 billion from improved patient safety with medications.
But the transition from paper records to a highly connected electronic national network could take about 15 years at an expense of $98 billion for hospitals and $17 billion for physicians.
Adverse Drug Events
Many have argued that one way EMRs and computerized hospital systems would cut health care costs is by reducing the number of adverse drug events (ADEs). Adverse drug events result in as many as 100,000 deaths per year; they account for about 40% of all hospital admissions and $2 billion of inpatient costs per year.
According to many studies, interventions like computerized physician order entry (CPOE) may reduce ADEs by as much as 25%. These projections have led to a widespread belief that CPOE and other electronic systems are essential factors in reducing the incidence of ADEs.
1. Hillestad R, Bigelow J, Bower A, et al: Can electronic medical record systems transform health care? Potential health benefits, savings, and costs. Health Affairs 24(5):1103-1117, 2005.
2. Nebeker JR, Hoffman JM, Weir CR, et al: High rates of adverse drug events in a highly computerized hospital. Arch Intern Med 165:1111-1116, 2005.
3. Koppel R, Metlay JP, Cohen A, et al: Role of computerized physician order entry systems in facilitating medication errors. JAMA 293:1197-1203, 2005.