The Children's Health Fund has long recognized the connection between high quality comprehensive health care and readily available usable medical information. As early as 1989, CHF and the New York Children's Health Project implemented an electronic health record (EHR) system to address the practical needs of maintaining accurate health care records in a mobile health care delivery setting. Expanding the use of information technology is key to improving health care quality, lowering costs and responding effectively to health care emergencies, including disaster-related events.
Since its inception, the New York Children's Health Project served, and continues to serve, children and families living in New York City's homeless shelters. Homeless shelters are often a brief stopping point for transient families. In addition to searching for a home, homeless families face numerous other challenges. Those challenges make focusing on healthcare extremely difficult. Proper handling of medical records is often neglected. As homeless families move, they change providers and medical records are misplaced, lost or nonexistent.
CHF responded to this problem with its first electronic record version in 1989. Although CHF moved on to develop more sophisticated systems, the first version revolutionized health care delivery for many homeless families. EHR addresses the practical needs of limited space on a mobile medical unit as well as the practical needs of providing continuous health care to a mobile population. EHR made it possible for more homeless families to maintain continuous health care by creating a paperless record system that compensated for the transitional nature of homelessness.
Thirteen of the seventeen programs in CHF's National Network have an electronic health record system that is accessible not only to CHF doctors and staff but also accessible to affiliated hospital systems. In its current iteration, CHF's EHR system provides a full and complete medical record including complete medical history, current medications, diagnosis and problems, and procedures. This complete picture of patients' health and medical information gives the provider a clearer and more comprehensive picture of the patient's health care history.
Health information technology is advancing at a rapid pace. Private insurance plans, private payers and government insurance programs recognize the potential benefits of EHR. It is estimated that standardized health information exchange and interoperability, the ability of different systems and programs to interact, will save could save more than $75 billion per year once fully implemented. However, a large percentage of savings and efficiencies will not benefit community-based primary care providers, particularly those serving disadvantaged populations. In moving forward, the greatest barrier to EHR adoption are lack of funding and resistance by physicians to adopt complex systems. It is imperative that government takes on a leadership role in addressing obstacles to coordinating health information technology. Although government is integral to attaining widespread interoperability of health information technology, other sectors must also lend their voice to achieve success.
CHF supports funding for the Office of the National Coordinator of Health Information Technology (ONCHIT) prposed by President Bush in 2004. Headed by Dr. David Brailer, ONCHIT is charged with greatly expanding interoperability of electronic health records within ten years. The 2005-06 proposed Federal Budget, includes $125 million in funding to the ONCHIT to carry out that plan.
CHF supports the development of regional health information organizations (RHIOs) to act as repositories of information for health care providers who are located in the same region to access patient information. The Department of Health and Human Services (DHHS) calls for the establishment of RHIOs in its Framework for Strategic Action.
CHF supports legislative and regulatory efforts to ensure that traditional providers of health care to medically underserved populations have access to EHR technology. To that end, these providers need vital resource support to incorporate EHR into their health care delivery system.
To access The Children's Health Fund response to the Office of the Coordinator of Health Information Technology Request for Information click here.
