GAO sees hurdles blocking e-records

Unclear standards, funding woes hurt Obamacare priority

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Government investigators say unclear standards and funding problems are thwarting medical providers from shifting to electronic health records and sharing their data, an ambition that’s supposed to save the U.S. health care system billions of dollars each year.

The Health and Human Services Department in August issued guidelines for the development and exchange of electronic health information in an increasingly digital world.

“However, the HHS strategy does not specify any such actions, how any actions should be prioritized, what milestones the actions need to achieve, or when these milestones need to be accomplished,” the Government Accountability Office said Monday in a new report.

Electronic health records are supposed to link up the fragmented health care system, producing better care at lower cost.

The lack of care coordination “can lead to inappropriate or duplicative tests and procedures that increase health care spending” that can range from $148 billion to $226 billion per year, the auditors’ report said.

Right now, providers can share records manually, such as by fax, but that is time-consuming and the documents might not be delivered in time.

The Health Information Technology for Economic and Clinical Health Act (HITECH), passed as part of President Obama’s 2009 stimulus law, provided funding to promote the adoption and use of electronic health records.

But the government’s auditors interviewed stakeholders in four states — Georgia, North Carolina, Minnesota and Massachusetts — and found insufficient standards, concerns about inconsistent privacy rules and difficulty matching patients to their records.

“Specifically, one provider noted that there are not sufficient standards to define allergic reactions, and another provider explained that some EHR systems classify an allergic reaction as a side effect, while other EHR systems classify the same reaction as an allergy,” the GAO said, in pointing to specific examples of mix-ups.

State laws are also inconsistent and getting in the way. For instance, people in Massachusetts and Minnesota reported that some states have stringent rules about sharing information about mental health, HIV or other sexually-transmitted infections.

Still others said records can be matched to the wrong patients, a major safety concern.

Given this backdrop, the auditors told HHS to develop more specific goals to carry out its electronic strategy, and to match it up with points on the calendar.

The agency said in its response to the GAO findings that it has begun to do that, and that the electronic exchange of health information “will be critical for the success of health care delivery system reforms” under Mr. Obama’s health care law.

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