The federal stimulus law has a timeline provision on electronic health records that has some data centers worried about whether they can meet the deadline.
The federal American Recovery and Reinvestment Act, which appropriates $19 billion to healthcare-related information technology, states that by 2014 each American should have an electronic health record (EHR) by 2014. But building out an IT infrastructure to support EHRs in will not be that easy.
"The concern is that when you have these programs that are time limited … that the quality of those implementations could go down," said Chad Eckes, the chief information officer for Schaumburg, Ill.-based Cancer Treatment Centers of America (CTCA). "There can be spectacular failures of electronic health records, because folks didn't anticipate what might happen if it was unstable, and that can have disastrous consequences for patient care."
Tom Roberts, the data center facility management director at Novi, Mich.-based Trinity Health, had slightly different concerns. He anticipates that over the next few years, he'll have to double or triple Trinity's data center environment to accommodate electronic medical records.
"Where are you going to get all this capital?" Roberts said earlier this year. "In five years, if you have all your clinical electronic medical records in the facility, you'll get a rebate. But you have to put that capital expenditure into place."
A recent New England Journal of Medicine report affirms Roberts' concerns, as it found that the No. 1 barrier to a comprehensive electronic records system was inadequate capital.
Still, not everyone thinks the deadline is such a bad idea.
"I think many organizations need a big push to get EHR in place, and there's nothing like a deadline to motivate people," said Alan Howard, the IT director at Princeton, N.J.-based Princeton Radiology. "No doubt some will fail, possibly due to being rushed into a poor decision. Even without a deadline, some implementations will still fail, though, so I don't give much credence to using time pressure as an excuse."
And even Eckes acknowledged that the upside to the timeline is that, as a believer in EHRs, he's happy the mandate will force the issue. "This isn't a matter of if you can go to electronic health records. It's a matter of when," He said.
CTCA, Princeton Radiology and Trinity Health have taken at least the first step toward EHRs, and in some cases, moved to the final stages. In December 2005, CTCA started down the path and, as a result, traded out its mishmash of servers -- mostly Dell -- for a total of 500 Hewlett-Packard ProLiant rack and blade servers.
Meanwhile, Howard helped oversee the digitization of Princeton Radiology's medical records, which range from x-rays and CT scans to patients' scheduling histories. Before that, company stored all its paper-based records in a warehouse that had grown to nearly 10,000 square feet. If it needed to retrieve records, it paid couriers, which added time and expense to the process..
Having all this work done gives Howard some relief. Still, he expects the 2014 deadline will be extended: "There are likely some organizations that will need more time, and most likely the deadline will be extended, as many are. Regardless, now is the time to start the implementation if it's not started already."
