The concept of streamlining health care operations—and thus health insurance processes—by standardizing electronic medical records is certainly not a new one, but after at least a decade of talking about it, we seem nowhere near a viable solution.
A recent report, “The Truth about HIPAA-HITECH and Data Backup,” on the datamountain.com website notes that 50% to 80% of electronic health record (EHR) projects fail. “We like to refer to an EMR or EHR implementation as the “Mother of all Wicked Problems,” says Bob Chaput, author of the report.
The report goes on to note several challenges to completion of such projects, not the least of which is that many medical practices and “business associates” simply lack the skills, knowledge and experience to undertake, much less complete such projects. The author adds that such entities have little expertise in “information technology in general and software projects with information security implications, in particular.”
How do we view this from an insurance perspective? First, it is useful to note that while insurance is not an industry on the technological cutting edge, it is a sector filled with companies and vendors that know our corner of the technology universe very well. There are certainly some companies that are ill-equipped to undertake a major IT project, but I don’t believe that is true in the majority of cases. On the other hand, some companies may be ill-funded for major IT initiatives, which is certainly a major stumbling block for EMR projects.
Another part of the difficulty with a major IT project involving electronic medical records is that such projects involve frequent interactions with other entities—providers, insureds, hospitals, pharmacies, regulators, etc.—who may or may not be up to speed on EMR.
An EMR system cannot succeed, or at least cannot be leveraged to its maximum potential, unless all the parts of the process are on the same page and operating at the same level of sophistication. That is not the case at present, and it will likely not be the case for some time. Surely no one would suggest that all of the players in the health care chain play nicely together, and this regrettable situation is indeed a hindrance to EMR systems, both local and national.
It is not at all shocking that 50% to 80% of EHR IT projects fail. It is common knowledge that about two-thirds of all IT projects fail to come in on time or on budget, or to be completed at all. Add to that the fiscal, staffing and expertise problems mentioned above and it is even less surprising. In fact, the real surprise may be that 20% to 50% of these projects succeed.
The federal government wants electronic records to be the standard, and they want it yesterday. Much as they may push, however, significant obstacles remain, and it may be that until the economy actually does stabilize (and don’t think for a moment that it has), progress will continue to be glacial.
Ara C. Trembly (www.aratremblytechnology.com) is the founder of Ara Trembly, The Tech Consultant, and a longtime observer of technology in insurance and financial services.
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