Overview of Electronic Health Records in Colorado

The mention of the electronic health record (EHR) scheme draws a variety of reactions from people. On the one hand, there are those who claim substantial cost savings as health insurance companies and medical providers will be able to inter-operate, while those on the other side of the board point to all the obstacles such as standardization and privacy issues.

Colorado however, has been a pioneer in digitizing health records and has been one of the first states in which hospitals across the state and spanning multiple disciplinary fields shared information with 500 emergency physicians. In this article, we take a quick look at some of the problems that are plaguing the adoption of such systems in Colorado.

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Hurdles to EHR adoption

Standardization

This is probably this single biggest issue facing EHRs today. The power of digitization manifests itself in the fact that different organizations can share patient information with each other. But there are many different proposed standards for sharing and different file types which make interoperability difficult. It's like the software of the two hospitals being unable to communicate because one of them speaks German. Clearly this will take some time to resolve because it's a winner takes all situation. There are vested interests and each group is interested in promoting its own standard.

Sharing Infrastructure

Another thorny issue is the question of networking. The most efficient technique is to have a centralized database of information to which each medical provider connects. This reduces redundancy, keeps a single point of entry and simplifies matters greatly. However, this model is highly susceptible to hacking and privacy violations. It makes it far too easy for a busybody to check up on somebody's health records.

The other model is like a peer to peer system where the information is scattered over multiple machines working together to present a cohesive picture. But once more, this relies on standards being adopted which everyone agrees to.

Cost

It can be incredibly expensive to implement EHRs on even a medium scale. The cost of the hardware and software alone can be prohibitive along with maintenance contracts. But even using workarounds such as open source software, it's expensive to train doctors and nurses and wastes productivity.

Summary

Most crippling of all, is the uncertainty that prevails over EHRs. No one wants to spend possibly millions of dollars on systems that may not be standardized and may never realize their full potential. While cost savings are significant in the long term, the system gives negative returns in the short term. Just like any business. The good news is that Obama seems pretty keen on implementing a nation wie system by 2014. Hopefully, he can push it through.

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