Medical ADP Systems:

Automated Medical Records Hold Promise to Improve Patient Care

IMTEC-91-5: Published: Jan 22, 1991. Publicly Released: Feb 25, 1991.

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Pursuant to a congressional request, GAO reviewed the potential benefits of and impediments to the use of automatic data processing (ADP) systems in managing medical patient care records.

GAO found that automated medical records could: (1) greatly improve patient care management due to their quick accessibility, improved accuracy, higher quality, increased versatility, and decisionmaking and quality assurance support; and (2) enhance outcomes research and increase hospital efficiency by improving staff productivity and reducing operating costs. GAO also found that many health professionals did not fully use automated medical records because: (1) they perceived such systems as difficult to operate and foreign to their practice of medicine, although this could be alleviated by emerging technology and adequate training; (2) the necessary technology for completely automating those records seemed too costly or was not yet fully developed; (3) of undeveloped standards for automating those records and lack of agreement within the medical community; and (4) of unaddressed security and privacy concerns and their potential legal implications.

Status Legend:

More Info
  • Review Pending-GAO has not yet assessed implementation status.
  • Open-Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.
  • Closed-implemented-Actions that satisfy the intent of the recommendation have been taken.
  • Closed-not implemented-While the intent of the recommendation has not been satisfied, time or circumstances have rendered the recommendation invalid.
    • Review Pending
    • Open
    • Closed - implemented
    • Closed - not implemented

    Recommendations for Executive Action

    Recommendation: The Secretary of Health and Human Services, as part of the Department of Health and Human Services' mandate to conduct research on outcomes of health care services, should direct the Public Health Service, through its Agency for Health Care Policy and Research (AHCPR), to support the exploration of ways in which automated medical records can be used to more effectively and efficiently provide data for outcomes research.

    Agency Affected: Department of Health and Human Services

    Status: Closed - Implemented

    Comments: AHCPR completed a series of studies on the availability of automated medical records data and the utility of such data in addressing medical effectiveness research questions. AHCPR joined with the National Library of Medicine to provide grants to develop test beds for the development of common medical terminology. AHCPR continues to sponsor and encourage public and private industry meetings that explore ways to increase the use of automated medical record systems to more effectively provide data for outcomes research. According to the head of AHCPR, the future of outcomes research is critically tied to the development of efficient ways for collecting data about treatments and outcomes of patients in the community and disseminating this information at the point of health service. He believes that AHCPR should have the lead role in the development of clinical data standards needed for the electronic medical records.

    Recommendation: The Secretary of Health and Human Services, as part of the effort to support outcomes research, should develop a plan and a budget for consideration by Congress, to bring about the greater use of automated medical records. This plan could include a national forum that sets goals for automating medical information, addresses individual and organizational concerns with automated records, and identifies incentives to induce health care organizations to increase their use of automation.

    Agency Affected: Department of Health and Human Services

    Status: Closed - Not Implemented

    Comments: AHCPR has no plans to develop a strategic plan and corresponding budget for HHS to submit to Congress to bring about greater use of automated medical records. HHS established a Computer Patient Records Council to examine the use and promotion of automated medical records. This Council met only twice and never met after January 1993. HHS also supported the Computer-Based Patient Record Institute in examining the role of automated medical records. The Institute developed a Standards Acceleration Plan to implement medical records standards and estimated that it would cost about $45 million to implement its plan nationally. Neither AHCPR nor HHS has developed a strategic plan and corresponding budget to submit to Congress to bring about greater use of automated medical records. Additionally, since AHCPR has no plans to develop a strategic plan and corresponding budget, it is unlikely that one will be developed in the near future to address this recommendation.

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