President Barack Obama's initiative to computerize the nation's health care records, if passed into law, will not directly affect Dartmouth-Hitchcock Medical Center, one of the few U.S. hospitals that already uses electronic records, according to Dartmouth Medical School professor Andrew Gettinger DMS '79, DHMC's medical director for information systems and informatics. The funding may benefit DHMC indirectly, though, by helping small, private practices computerize their records, allowing DHMC and local primary care providers to share the patient information, Gettinger said.
The $825-billion stimulus package passed Wednesday by the U.S. House of Representatives includes $20 billion for medical institutions to computerize their medical records within the next five years.
Health care experts have said the transition will likely improve patient care and will lower health care costs. A 2005 study by the RAND Corporation found that implementing a computerized health care system could eventually save more than $81 billion annually.
"What the Obama administration is following up on is the promise of health information technology improving patient care and decreasing cost," Gettinger said.
DHMC, which has used electronic medical records since the early 1980s, is working to replace its current system. The update, which should be complete by 2011, may not receive federal support, as institutions that still use paper medical records will probably have priority, Gettinger said.
DHMC developed its current electronic medical records system in the early 1990s in-house, as none of the products on the market at the time met the medical center's needs, Gettinger said. DHMC decided to make the transition to a program developed by Epic Systems approximately two years ago, Gettinger explained, because the company's product has more capabilities than anything the medical center could develop on its own. The transition is still ongoing.
In addition to helping medical institutions that still use paper medical records, the program will benefit hospitals that have already changed to electronic systems by making record systems from different hospitals and doctors' offices compatible with each other, Gettinger said.
"Where I see that the federal government could make a difference is to help other places implement electronic systems and make it inter-operable," he said.
DHMC could provide more efficient care, he explained, if all primary care providers that refer patients to DHMC entered patient information into compatible electronic records systems.
"Say a doctor from [Littleton, N.H.] wants to send a patient for a consult," he said. "He could enter [the patient's] information into our system, and then we could send back what we find. It would be much more effective."
DHMC gives 1,600 health care providers throughout the Upper Valley free access to its electronic system, Gettinger added, but cannot afford to help private practices convert their records, a process which costs about $50,000 per system.
Gettinger said federal funding will likely accelerate progress towards a nationally standardized electronic records system, but was not certain whether the stimulus package will be sufficient.
"[The funding, if passed,] is way better than it was in the previous administration, but it may not get us all the way there," he said.
Computerizing medical records nationwide will require an initial investment of at least a $115 billion, according to the RAND report. The authors of the study recommended implementing the changes over a 10- to 15-year transition period.
