EHRs can, in fact, improve the quality of care, at least at large, integrated delivery systems, says a new report from the Government Accountability Office. But even major provider organizations continue to struggle to share EHR data outside of their own networks.
The GAO report, required by the Health Care Safety Net Act of 2008, says that EHRs support care coordination, disease management, computerized physician order entry, e-prescribing and adherence with care protocols at many of the 15 public and private delivery networks the federal agency studied. Operating a health plan and employing physicians also can help bolster care quality, the GAO says.
"According to officials at some IDSs, using EHRs facilitates care coordination because EHRs make patient clinical information more readily available to providers and improve communication among providers, staff, and patients. For example, officials from Denver Health characterized the EHR as a key component of integration. At Denver Health, the EHR supports care coordination because physician notes from patient encounters are scanned in within 24 hours of patient contact and clinical information, such as previous laboratory tests, is available to all providers," the report says. "Similarly, an official from Mayo Clinic told us that the EHR helps avoid overutilization and duplication of services, and an official from Partners Healthcare told us that the EHR aids in care coordination because physicians can see patient clinical information no matter where in the system the patient is."
All 15 of the IDSs studied had some form of EHR, according to the report. The GAO even provides a specific definition: "An EHR is an electronic collection of information about the health of an individual or the care provided, such as patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EHR can also support other care-related activities, including evidence-based decision making."
Still, some of the health systems reported facing many of the usual challenges with implementing EHRs, including difficulty in sharing data with outside organizations. They also lamented the lack of reimbursement for care-coordination services.