Electronic Health Records and the National Health Information Network: Affordable, Adoptable, and Ready for Prime Time?
This issue contains 2 articles on different aspects of the “wiring” of health care in the United States. One article details the costs and difficulties of implementing an electronic health record (EHR) system in an internal medicine practice, and the other estimates the costs of building a national health information network (NHIN). Baron and colleagues (1) recount their small practice's predictable struggles and ultimate success with implementing an EHR. Their narrative is compelling and tells a story that many physicians will find useful and instructive. The authors also offer suggestions that could make this complex process easier for those who follow their lead. Kaushal and colleagues (2) approach the “decade of the EHR” from a national perspective, telling policymakers and politicians how much money they should allocate to build the infrastructure—almost $400 billion over 5 years—if indeed the United States is serious about moving from a siloed, paper-based system to one that is electronic and fully interconnected.
While the rationale for moving the patient's health record off paper is clear—making care better, safer, and more equitable (3)—we don't know what exactly the transformed system will ultimately look like or how we will get there (4). Both articles in this issue raise questions that relate to this vision, as well as affordability and tactics. Will meaningful health care transformation follow easily after EHR adoption or systemic interconnectivity? Are EHRs and the NHIN interdependent? Is the EHR affordable for the average small practice? Can the United States afford the NHIN? How can we make EHR implementation and secure connectivity easier and less costly?
The EHR seems to be the ideal point-of-care …
This 100-word excerpt has been provided in the absence of an abstract.
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