How, in today's digital world when complex transactions such as banking and shopping can be done online – or even via cell phone – is it possible that doctors don't have instant access to a patient's up-to-date health care records and medical information?

Going to a new doctor, seeing a specialist or checking into the hospital sets off a manual paper trail of tracking down health records from multiple doctor's offices – and it's the seniors and caregivers who shoulder the responsibility of gathering and distributing a complete medical history. This manual process leaves a wide margin of error, due to the patient's inability to recall, or failure to divulge, past medical problems and a complete list of medications.

Shared Electronic Health Records (EHR) could change health care forever. Adoption of standardized systems and processes is underway, but the initiative will take years.

Majd Alwan, vice president of LeadingAge's Center for Aging Services Technologies (CAST), a not-for-profit organization that tracks and promotes aging technologies, paints a grim picture of what can go wrong when manual processes are used. "The vast majority of older adults have two or more chronic conditions," he says. "Over 50% of Medicare beneficiaries have five chronic conditions or more. Multiple care providers are prescribing medications and making care plans without having complete information. Patients are moving from one care setting to another – hospital, short-term rehab, assisted living, or home – but their vital health records aren't transitioning with them. This results in medication errors, life-threatening drug interactions, unnecessarily repeated tests and sometimes misdiagnosis. To combat this problem, a patient's health information must be as complete as possible and available when and where it is needed – not locked away in one office or another."

The good news is that the health care industry has taken steps to make electronic health records a reality. Doctors are starting to document care using laptops, tablets and handheld devices during in-person visits, and authorized health care professionals in any care setting will soon be able to securely access a patient's health information whenever they need it. But we're not there yet.

A big step in the right direction was passage of the Health Information Technology for Economic and Clinical Health Act in 2009, aimed at creating inter-operable electronic health records by 2014. It appropriated $46.8 billion to encourage hospitals and health-care professionals to adopt certified EHR technology.

All states received funds from the federal government to create the infrastructure to facilitate health information exchange. Medicare-eligible health care professionals can receive up to $44,000 over five years if they begin participating by 2012. Incentive payments for eligible hospitals and critical-access hospitals began this year, beginning with a $2 million base payment.


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As an example of the modernization efforts, Arizona, which received $17 million, built a web-based health information exchange that gives hospitals and providers access to hospital discharge summaries, medication lists, and laboratory information at the point of care.

More recently, Office of the National Coordinator for Health Information Technology Challenge grants were awarded to 10 state Health Information Exchange entities to encourage breakthrough innovations to support nationwide health information exchange and interoperability. Colorado, Maryland, Massachusetts and Oklahoma received about $1.7 million each to engage long-term and post-acute care providers.

The biggest obstacle in EHR is rolling out the massive initiative to hundreds of thousands of doctors, hospitals, labs and care facilities across the nation. Funding is a crucial component, since the implementation of a health information technology infrastructure can be costly and time-consuming.

So, when will a seamless, nationwide system for health information records become a reality? No one knows for certain. Collaborative initiatives among organizations like the American Health Information Management Association (AHIMA), the American Health Care Association, Long-Term and Post-Acute Care Health Information Technology Collaborative, and CAST are working to spread the word, motivate providers to adopt EHR and increase knowledge through education and accreditation, professional credentialing, standards-setting, policy-making and issue advocacy. But all stakeholders, including patients, will have to take part for the system to work, according to AHIMA.