Increased use of electronic records promises to help improve heathcare – but it also poses many challenges. That was a key point as plans by a coalition of health organizations to build a statewide electronic information network were announced yesterday by state officials.
The goal is to create a single, secure network that will make it easier for providers to access their patients’ medical histories, information on medication allergies and lab test results, particularly when the patient has doctors who are not part of the same information-sharing organizations.
State Health Commissioner Mary E. O’Dowd said state officials expect the $1.57 million New Jersey Health Information Network to begin operating in 2014.
More than 2,000 doctors will be able to use the network when it launches. State officials expressed hope that the network will make it easier for doctors to quickly access patient information currently stored by separate organizations.
“We anticipate that these members and these numbers will continue to grow over time, in particular as we see the expansion of the power of the exchange of this data, because they will not want to be left behind in the dust,” O’Dowd said. “Peer pressure is a very powerful force.”
O’Dowd made the announcement at a health information technology summit held by the New Jersey Technology Council, which represents technology businesses.
Summit participants noted that information technology has been useful in improving healthcare, but said many barriers have prevented IT from fully realizing its promise. These problems will likely remain even as the statewide network is rolled out.
For instance, when different providers share a patient’s information, they can still have difficulty using it because they use different formats. One doctor may summarize essential patient information quickly, while another might write several-page reports that can be time-consuming to read.
New Jersey State Nurses Association President Patricia Barnett said some of those who could benefit the most from providers using IT to send text messages with reminders about medication or appointments aren’t in a position to receive these messages.
“Often they are poor, they don’t have access to care and they don’t have smartphones,” Barnett said, adding that these patients may also be elderly or not able to speak English. “They’re the people who are being left out of this electronic age.”
Barnett also noted that the complexity of electronic health records can even trip up providers within the same health system, such as a hospital that uses different electronic-record formats for its emergency department and its inpatient admissions.
“It’s time-consuming and there’s a real opportunity for patient error,” Barnett said.
While the network announced by state officials yesterday could give providers quicker access to a wider range of records, it won’t resolvethe problem of providers using different formats.
Dr. Paul Katz, dean of Rowan University’s Cooper Medical School, said that while information technology can be useful in improving patients’ knowledge about their own health, there are barriers preventing people in low-income areas from receiving the same benefits as higher-income patients.
Katz said some of the greatest potential for using technology is in applications targeted toward children, such as programs teaching young people what to eat and how to take safety precautions.
He added that some uses of technology – such as companies that make extravagant claims about being able to provide people with useful information about their genes – may do more harm than good.
“There’s a great example of people with too much money investing it in things they probably shouldn’t be, without much regulatory control of the information they’re getting back,” Katz said.
Barnett said some patients are becoming smarter about their own health by using technology, but they remain in the minority.
“The question is, how do you translate that down to the rest of the population, who either doesn’t have access to that kind of technology or who have not been told, ‘You really are accountable for yourself,’ ” she said, adding that if providers aren’t successful in reaching that population, then some “million-dollar patients” will remain frequent and expensive users of healthcare.
Technology can be used to reduce healthcare disparities, according to Dr. John Lumpkin, senior vice president and healthcare group director for the West Windsor-based Robert Wood Johnson Foundation and a speaker at the summit.
Through the use of data, healthcare can be tailored to individual patients, Lumpkin said.
“We can do better and it’s information systems that will bear the burden of getting information into the form where it can be read by regular people,” Lumpkin said.
He said this will be important in turning the United States from its current position of having the best medical science in the world to one in which it has the best medical care in the world.
“While the future is here, it’s just not very evenly distributed,” Lumpkin said of the current state of healthcare.
Current medical practitioners also highlighted the importance of technology.
Dr. Gabriela Bowers, an East Windsor-based internal medicine doctor, said her practice has relied on electronic records since it was founded in 2004.
“It’s real helpful, particularly when it’s not one of your patients that you’re seeing,” Bowers said, adding that it remains challenging to integrate additional health data into the records. “If data isn’t simple and readily available, it’s going to be difficult for us to use.”
Bowers expressed disappointment with one aspect of the system that is a recurrent theme among some doctors: Every practice uses its own format through one of 150 different electronic medical record companies.
“Notes from a different system are difficult to read,” Bowers said.
Health policymakers may need to step in to improve the ability for records to be used across different systems, according to Al Campanella, Virtua’s executive vice president of strategic business growth and analytics.
"A little more regulation and policy probably is warranted,” he said.
Jon Cooper, CEO of LifeVest Health, talked about creating economic incentives for reducing the long-term risks of illnesses. His company is working on such a market-based approach inspired by carbon-pricing proposals in energy policy.