Health I.T. Failure

Socialized medical records


Britain's National Health Service (NHS) may offer the best possible environment in which to test a government-run electronic medical record system. The system is fully socialized, with a single government payer, universal enrollment, and doctors employed directly by the state. There are roughly 60 million beneficiaries, enough to see if integrated electronic records can work on a large scale but perhaps not so many that the process of creating and maintaining those records will necessarily be overwhelmed. And the NHS is popular within all of the country's major political parties. 

Yet despite the health system's high level of integration, a decade-long attempt to implement a large-scale information technology network has failed. In February the NHS announced that it had canceled a multiyear, $20 billion health I.T. project after a 2011 government report concluded that it was impossible to deliver on the plan's ambitious goals. In their report, the nine members of Parliament's Public Accounts Committee branded the program "unworkable," saying it "has proved beyond the capacity" of the NHS to implement. 

The failure of the NHS system follows a poor showing by a similar effort in the United States. The 2009 stimulus package included $30 billion to help fund a major health I.T. rollout here. In addition, doctors are spending an average of about $40,000 each to build electronic health record systems in their offices. Yet health industry analysts report that despite the expense, few medical providers are able to share records across practices. 

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  1. All the major insurers use electronic claim forms for submission to the Center for Medicare Medicaid Services. CMS handles billions of these records per year, each one containing at least one diagnosis and one procedure code.

    Meanwhile, private companies have been adopting EHRs, like the 200,000 physicians and groups, which have adopted EPIC, the industry leader in EHRs.

    I manage the software development of an EHR system, and have for the last couple of years. Our small company was recently bought out by a multi-billion dollar company, interested, in no small part, by our EHR system.

    There isn’t any real failure in the system, except that some companies, who developed tried and true practices before the ubiquity of the desktop computer, have a tougher time seeing the value of modernizing than other companies, which might be newer.

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