Merely spending $19B to spur the use of electronic health records (EHR) does not guarantee that the plan will succeed. A study funded by the Robert Wood Johnson Foundation reports that only 9% of the US hospitals have EHRs. As well, the American Medical Information Association reports that there is need for about 70,000 medical informaticians who are trained in medical records and claims, and clinical care. It seems unlikely that EHR will succeed without properly trained individuals since they are critical to the success of implementing EHRs.

Big Divide

With only 9% of the US hospitals who actually have EHRs that means millions of people in rural US are currently “have nots.” However no question that there are many hospitals implementing EHRs since there are major medical systems from EPIC Systems, Eclipsys, Cerner, GE Healthcare, McKesson, and Siemens AG being implemented throughout the US. These various medical systems provide EHR for millions of patients. For example Epic claims to have 175 customers representing about 22% of the US population, approximately 70 million patients. So clearly there are a significant number of patients who either have EHRs now, or will soon.

HIPAA Connection

I have never been a big fan of HIPAA (Health Insurance Portability and Accountability Act of 1996) given the cost and benefit to patients. It seems pretty clear that the 18 elements protected by HIPAA are easily available from various sources on the Internet. It’s not hard to find home addresses, phone numbers, social security numbers, birth dates, email addresses, to name a few. It’s not clear how much money was spent on HIPAA, and to what end? Medical care providers spent a fortune, and many vendors profited, but it’s not clear that medical privacy is any better today than it was when HIPAA was created in 1996. Without question the growth of the Internet has made personal information a greater challenge to protect.

So it seems highly unlikely that just spending $19B will ensure that EHRs will be a success.