Searching For Healthcare Solutions: Electronic Health Records Initiative Faces Significant Obstacles

When the long rumored Google Health was announced in early 2008, it appeared to be a very ambitious initiative that had a mountain to climb. That mountain was participation: getting individuals, doctors and hospitals to digitize their records. Then there are the myriad privacy and data security issues.

But Google isn’t the only one in the electronic health records and “health search” game. So is Microsoft. There are scores of others in the segment, as well as billions spent annually in advertising. Despite the money and involvement of companies like Microsoft and Google, digitizing the nation’s health records and getting millions of people to use online tools to manage their health histories seemed an almost insurmountable goal in early 2008.

Then came the election of Barack Obama.

As part of its economic recovery program, the Obama Administration has proposed a multi-billion dollar effort to upgrade the US health care system by making all health records electronic within five years. The idea is that over time it saves money, delivers efficiencies, helps improve the quality of healthcare and overall costs in the system will decline. That effort has given Google Health, Microsoft Health Vault and others a major hypothetical boost. But major challenges remain.

According to a story in the NY Times, two separate medical journal articles identify a range of problems and obstacles to achievement of the Obama Administration’s goal:

Two articles, to be published on Thursday in the New England Journal of Medicine, point to the formidable obstacles to achieving the policy goal of not only installing electronic health records, but also using them to improve care and curb costs.

One article reports that only 9 percent of the nation’s hospitals have electronic health records, based on a survey of nearly 3,000 hospitals . . .

In a second article in the journal, two experts in health information technology at Children’s Hospital Boston assert that spending billions of dollars of federal funds to stimulate the adoption of existing forms of health record software would be a costly policy mistake.

The second article advocates development of an open software platform rather than working within the existing records framework. It’s not clear to me how open-source software would affect Google or Microsoft’s health-related ambitions — probably not significantly.

Billions are literally at stake in answering these questions, however.

Eventually there will be an electronic database of health records in the US. That will certainly yield public and private health benefits as well as cost savings to the system. (Privacy and policy issues preventing abuse will have to be addressed as part of the effort.)

The big unknown is how long it will realistically take to develop that system and whether, if it takes many years, Google or Microsoft will have the patience to wait that long.