NCPA - National Center for Policy Analysis


May 10, 2010

A national electronic health record (EHR) system may not be feasible, nor save as much as the government has claimed, concludes a report by the National Center for Policy Analysis. 

In "Health Information Technology: Benefits and Problems," NCPA senior fellow Devon Herrick and Linda Gorman focus on the intended results of provisions in the American Recovery and Reinvestment Act (ARRA) signed by President Obama in February of 2009: 

  • The ARRA included guidelines for incentives starting in 2011 and penalties beginning in 2015 from Medicaid and Medicare for physicians, hospitals and other providers for implementing or failing to implement EHR systems.
  • It also instructed the Office of the National Coordinator for Health Information Technology within the Department of Health and Human Services to helm the creation of a nationwide Health Information Technology (HIT) system.
  • The system was promoted as a method of increasing security of medical records, reducing health care costs, and improving quality and interoperability between medical establishments.  

"I don't think the government has a good track record of imposing its will from the top down with systems that will meet the needs of those at the bottom that are expected to use it," said Herrick.  "Our conclusion is you have to get the incentives right, and that's not always easy under our third-party payment system." 

The authors found deeper flaws in the proposed system of health records which put it intrinsically at odds with some of the goals of HIT visionaries.  According to Gorman: 

  • The first thing we need to do is have a very clear notion of who owns these medical records and who has the right to make changes to them.
  • Historically it has been physicians, because the records have existed only for physicians to make decisions about patient care.
  • These records have historically been separate from billing records; with the advent of major government payments, there has been pressure to combine them. 

There's a fundamental tension between records for patient care and records for billing, and that tension's got to be resolved, says Gorman. 

The authors found claims of savings to be realized from a broad shift to HIT may have been greatly exaggerated.  The Congressional Budget Office (CBO) found potential for savings of $78 billion annually, but Gorman sees these massive savings claims as baseless. 

Source: Rob Goszkowski, "Electronic Health Records May Not Be Good Cost-Cutter," Heartland Institute, May 10, 2010. 

For NCPA study: 


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