Two points – EHR and the government’s incompetence

Bill Sota posted a brief piece about the Veterans Administration’s adoption and use of Electronic Health Records, citing: “Good news on the cost savings performance of Vista which is the VA’s electronic medical record system:”
Bill is referring to the primary source, an article in Health Affairs:
“The VA spent proportionately more on IT than the private health care sector spent, but it achieved higher levels of IT adoption and quality of care. The potential value of the VA’s health IT investments is estimated at $3.09 billion in cumulative benefits net of investment costs.” [emphasis added]
Two points.
1. The VA is a very, very large health system that has implemented an EHR program and saved taxpayers over $3 billion dollars – so far. Implementing EHR is difficult, time-consuming, and a lot of work. Yet it can, and has, been done.
2. This is a creditable result, and one that should encourage other integrated health systems to find out what the VA has done and, perhaps, do something similar. After all, if the gubmint can do it, it should be child’s play for the vaunted free market…
Unfortunately, it appears as if the private sector isn’t as competent in this area as the VA. Within the article itself are a couple telling conclusions. First, the VA spends considerably more (as a percentage of total expenditures) on IT than the private sector does. Yet the VA’s ratio of IT capital spending to total spending is considerably less than the private sector’s.
The VA spends more on IT, with a big chunk of that invested in implementation and maintenance. And the results show the impact:
“The VA has achieved close to 100 percent adoption of several VistA components since 2004. In contrast, the private health care sector has not reached significant adoption of any of these systems. Adoption in the private health sector of inpatient electronic health records stands at 61 percent; use of inpatient bar-code medication administration is at 22 percent; computerized physician order entry adoption stands at 16 percent; and outpatient electronic medical record adoption is at 12 percent”
Finally, the implementation of the VA’s VistA system has delivered significant improvements in the quality of care delivered. Here are just a couple examples (quoted from the articleº:
– For preventive care process measures such as cancer screenings, the VA had higher performance during 2004-2007 relative to the private health care sector
– VA patients with diabetes had better glucose testing compliance and control, more controlled cholesterol, and more timely retinal exams when compared to the Medicare health maintenance organization (HMO) private-sector benchmark.
– The VA averaged about fifteen percentage points higher than the private sector on preventive care for patients with diabetes and seventeen percentage points higher for patients with diabetes who have well-controlled cholesterol
What does this mean for you?
EHR can, and has, delivered significant savings and RoI while increasing quality.
The next time someone bemoans the government’s incompetence and complete lack of ability to run anything, tell them about the VA. And tell them to stop parroting Fox talking points; they are a poor substitute for actual thinking.