TEPR speakers urge HIT adoption, but stories reflect a lack of progress

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If the opening session speakers at the Medical Records Institute annual conference Towards the Electronic Patient Record (TEPR 2006), held this week in Baltimore, were anything to judge by, widespread adoption of electronic health records isn’t likely in the near future.

Year after year, C. Peter Waegemann, CEO of the Medical Records Institute, has spoken about the coming healthcare IT revolution. However, 22 years ago at the first TEPR conference, some speakers thought electronic medical records would be here within three years, then 10. But, more than 20 years later, rather than a paperless healthcare industry, the stakeholders are still debating different standards.  “There is no reason to wait,” he said. “It’s the only way to go. We need to get serious about IT as a nation,” Waegemann said.

The federal government must make substantial investments in healthcare IT and stop cutting physician reimbursements if the United Sates is to reap the benefits of a wired healthcare system, said Joseph Heyman, MD, secretary of the American Medical Association. He accused the government of sending mixed messages. Doctors cannot be expected to make substantial investments in technology when their Medicare reimbursement payments are cut and the cost of care increases, Heyman said.

The government also should do more to help the 46 million uninsured Americans, he said. “All of the accomplishments with health IT are worthless if patients cannot access care,” Heyman said.

Phil Sissions rounded out the roster of TEPR 2006 opening session speakers. He recently left the United Kingdom's much-watched NHS' National Program for Information Technology (NPfIT) and provided a pretty critical account of the progress to date for the single largest program in healthcare IT. The only real successes were getting broadband into the various hospitals and practices and getting some PACS systems up. Getting doctors their own email address was somewhat mockingly called the biggest achievement. Sissions said that many of the other programs, including the Choose and Book appointment system are barely being used and that general practitioners revolted when they were told that they had to change their practice management systems.

So far the project has spent hardly any of the money allocated to it (about £650 million each year) because most of the contracted software hasn't been delivered. Meanwhile, local hospitals and physician authorities have little money for process change and have stopped much IT development progress waiting for the central program to provide for them.

Despite the auspicious opening, TEPR 2006 included more than 250 speakers across nine educational tracks and 180 EMR and HIT-related vendors in the exhibit hall. It also included the staging of the largest demonstration of wireless locating and tracking technology ever in healthcare. About 500 attendees participated by having their conference badges equipped with RFID tags. Real-time data of their whereabouts were accessible on workstations in freestanding kiosks in the exhibit hall and conference lobby area. By being able to locate mobile assets and people within a designated space, the system presents a real-world application for hospitals and mimics a hospital environment. The demonstration included four zones that were designed to mimic a busy urban hospital – Emergency Department, Perioperative Suite, Lab, and Hospital Room.

The Medical Records Institute (MRI) teamed with Parco Wireless and Patient Care Technology Systems to set the demonstration. “Managing patient flow is one of the hot topics for any hospital,” said Waegemann. “Today’s tracking technologies can generate significant cost savings derived from more accurate data collection,” said Scott Cohen, CEO of Parco.