Question

Assignment title or task:
(You can write a question) Dr. Buthainah is a family physician who refuses the use of EHR in her clinic because she believes that her patients' health information is not secure in the EHR. As a health informatics specialist, write a 150-200 words letter explaining to her actions that have been taken by governments and professional bodies to safeguard EHR data.

Answer 1

Federal and state governments, insurance companies and other large medical institutions are heavily promoting the adoption of electronic health records. The US Congress included a formula of both incentives (up to $44,000 per physician under Medicare, or up to $65,000 over six years under Medicaid) and penalties (i.e. decreased Medicare and Medicaid reimbursements to doctors who fail to use EMRs by 2015, for covered patients) for EMR/EHR adoption versus continued use of paper records as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the, American Recovery and Reinvestment Act of 2009.^[1]

EHR adoption of all physicians in the US. Source: DesRoches et al. (2008).^{[needs update]}

  Fully functional EHR system (4%)

  Basic EHR system (13%)

  Bought but not implemented yet (13%)

  EHR purchase planned in 2 years (22%)

  No EHR system (48%)

The 21st Century Cures Act, passed in 2016, prohibited information blocking, which had slowed interoperability.^[2] In 2018, the Trump administration announced the MyHealthEData initiative to further allow for patients to receive their health records.^[3] The federal Office of the National Coordinator for Health Information Technologyleads these efforts.^[4]

One VA study estimates its electronic medical record system may improve overall efficiency by 6% per year, and the monthly cost of an EMR may (depending on the cost of the EMR) be offset by the cost of only a few "unnecessary" tests or admissions.^[5][6] Jerome Groopman disputed these results, publicly asking "how such dramatic claims of cost-saving and quality improvement could be true".^[7] A 2014 survey of the American College of Physicians member sample, however, found that family practice physicians spent 48 minutes more per day when using EMRs. 90% reported that at least 1 data management function was slower after EMRs were adopted, and 64% reported that note writing took longer. A third (34%) reported that it took longer to find and review medical record data, and 32% reported that it was slower to read other clinicians' notes.^[8]