Health Care CIOs Warn Of Hurdles To Electronic RecordsHealth Care CIOs Warn Of Hurdles To Electronic Records

Electronic patient records promise big savings in health care, but two CIOs at the information 500 Conference warned today that "IT is not the answer to every business problem" in health care.That comment came from Lynn Vogel, VP and CIO at The University of Texas M. D. Anderson Cancer Center in Houston, Texas, a $2.8 billion clinical and teaching institution representing about 30% of the university's budget.

Vogel cited the varying interests pitted against each other in health care, such as hospitals that are rewarded for minimizing the number of days a patient stays in the hospital versus doctors who are paid on a basis of the number of visits to a patient in the hospital.

"The hospital has a strong incentive to get you in and out. Its payment will be the same if it's one day or multiple days. The doctor has exactly the opposite incentive," he noted in a panel on "Getting Health Care Under Control: How IT Can Step Up To The Plate."

When electronic patient care records get implemented, it tends to be within one organization. "When you travel to the M. D. Anderson Cancer Center for treatment of your prostate cancer, your medical record doesn't travel with you," warned Dan Drawbaugh, CIO at the University of Pittsburgh Medical Center.

The University of Pittsburgh Medical Center implemented electronic patient records with careful advance planning, Drawbaugh said, only to find that behavioral health, oncology, and transplant patients needed their own specialized records.

The business of health care is one of the most complex in the United States, Vogel added. He said he spoke to only two people to complete his plane flights to get to the conference, including airline boarding personnel. But a seriously ill patient needs to talk to 20 or more people, each with their own specialties and responsibilities in the system.

A questioner in the audience asked how long-term savings can be achieved when so many interests were pitted against each other, with little interest in making long-term investments to bring down costs.

Drawbaugh said 60% of health care is paid for by the federal government, giving it leverage to impose standards. But doctors, who need to make up the base of the electronic record pyramid, "don't directly benefit from electronic health care records" and still have little incentive to adopt them.

In a tidbit of information, Vogel pointed out that Texas is seeing the greatest influx of doctors of any state in the country because of its $250,000 cap on doctor's medical liability. New Jersey, on the other hand, is losing its midlevel delivery room and midwife personnel as well as obstetricians because of its high cap on medical liability.