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Health Care Reform:

Health Insurance & Affordable Care Act

Technology Plays Key Role in Health Care Reform

But will technology cause us to sacrifice our privacy?

EMR: The privacy pitfall continued...

The benefits of EMRs are real, but so too are the barriers, Savard says. “Health care information is the most private and the safeguards can’t be strong enough, and we may not ever get over this barrier.”

The fear factor is two-fold: general Internet security and confidentiality,says C. Martin Harris, MD, the chief information officer at the Cleveland Clinic in Ohio.

“Most people are really expecting the organization to manage technical security such as the threat of hacker,” he says. On this front, the fears – and their antidotes -- are among the same as they are for doing your Christmas shopping with a credit card.

“The differential is really related to confidentiality of medical records,” he says. The fear is that someone, say an insurance carrier, could get access to information, and use it against you.

Although you can’t prevent such a breach, certain safety nets may make it less enticing to any and all potential voyeurs. “Audit trails in some systems can tell you who looked at your records, when they looked and what page they looked at,” Harris says. This may be a major disincentive.

Any safety net will be put through the ringer if a universal electronic medical record is developed and implemented, Rubin says.

EMR: Who should foot the bill?

Privacy issue is one major barrier, but cost is the other. Ashish Jha, an associate professor of health policy and management at Harvard School of Public Health, estimates that it could cost anywhere from $20 million to $200 million per hospital over several years to put these systems in place. It would cost one doctor’s office about $50,000.

Currently, fewer than 10% of U.S. hospitals are using electronic medical records in a basic way, he found.

Other studies have estimated the overall cost at $75 billion to $100 billion over 10 years.

“The costs are astronomical,” Savard says.

President Obama is hoping to offset these costs by offering a total of $20 million in stimulus funds to hospitals and doctors who exhibit a “meaningful use” of electronic medical records by 2011. Meaningful use implies that health care providers use a electronic medical record, exchange data and submit information to the government on clinical quality measures.

“The stimulus bill tends to take the direct costs off of physicians, but it’s a reimbursement model, so doctors need to first make an investment and use the system properly to get their money back,” Harris says.

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