Alexander: New HHS Rules Should Improve Electronic Health Records To Give Patients Better Outcomes, Better Experiences at a Lower Cost

Posted on March 26, 2019

“I want to be aware of unintended consequences from these rules: Are these rules moving too fast? In 2015, I urged the Obama Administration to slow down the Meaningful Use program, which it did not do, and looking back, the results would have been better if it had.  Are the standards for data elements too rigid?  Is the door still open for bad actors to game the system and continue to information block?  And how can we ensure patient privacy as patients gain more access and control over their personal health information. And how do we help them keep it secure? I want to ensure these rules will make the problem of information blocking better, not worse.”  – Sen. Lamar Alexander

WASHINGTON, D.C., March 26, 2019 – Senate health committee Chairman Lamar Alexander (R-Tenn.) today said, “Having electronic health records that talk to one another – we call that interoperability – is one way to reduce what we spend on administrative tasks and unnecessary care.”

“In 1991, the National Academy of Medicine released a report urging the ‘prompt development and implementation’ of what were then called computer-based patient records,” Alexander said. “Electronic health records got a boost in 2009 when the federal government began the Meaningful Use program, spending over $36 billion in grants to incentivize doctors and hospitals to use these systems. The hope was electronic records would improve patient care and reduce unnecessary health care spending. But in 2015 – six years after the Meaningful Use program started and as the 1991 report predicted – we realized that, in many cases, electronic health records added to administrative burden and increased unnecessary health care spending. So, in 2015, this committee held six bipartisan hearings and formed a working group to find ways to fix the interoperability of electronic health records.”

Chairman Alexander made his remarks today at a Senate health committee hearing on implementation of the electronic health information provisions in the 21st Century Cures Act. In the Cures Act, Congress took steps to help improve the exchange of electronic health information. Last month, the U.S. Department of Health and Human Services (HHS) released two rules to define information blocking—so it is clear when one system is purposefully not sharing information with another—and to give patients more control over their records and providers more information so they can better treat their patients.

“According to the U.S. Department of Health and Human Services, these two new rules should give more than 125 million patients easier access to their own records in an electronic format,” Alexander continued. “This will be a huge relief to any of us who have spent hours tracking down paper copies of our records and carting them back and forth to different doctors’ offices. The rules will reduce administrative burden on doctors so they can spend more time with patients.   A recent study from Kaiser found that emergency room doctors, in order to use electronic health records systems, make up to 4,000 mouse clicks per shift.  According to HHS, spending less time on these administrative tasks will improve efficiency and therefore could save $3.3 billion a year.”

Alexander told the story of Reid Blackwelder, a family physician with three clinics in the Tri-Cities area of East Tennessee: “A few years ago, Dr. Blackwelder talked to the New York Times about the electronic health records that were supposed to make his life easier, saying, ‘We have electronic records at our clinic, but the hospital, which I can see from my window, has a separate system from a different vendor. The two don’t communicate. When I admit patients to the hospital, I have to print out my notes and send a copy to the hospital so they can be incorporated into the hospital’s electronic records.’ Dr. Blackwelder could pay for his patients’ hospital records to be electronically sent from his system to the hospital’s system– but it would cost him $26,400 every month – or $316,800 a year. For Dr. Blackwelder, and so many other doctors, record keeping is now more expensive and burdensome.”

The Senate health committee had six hearings in 2015 to explore ways to get our nation’s system of health information technology out of a ditch and make it useful for doctors and patients. The committee then authored the 21st Century Cures Act which directed HHS to make proposals to improve electronic health records.

You can read Alexander’s full prepared remarks here.