EHRs And Multi-Provider Use: Lessons From The VA

With billions of dollars of stimulus funds available and the President and state governors promoting them, electronic health records (EHRs) are likely to become commonplace in the U.S. health care system. To be sure the transition will be complex and costly, but incentives provided by insurers and the federal government for quality improvement tied to EHR use will encourage providers to enter the brave new electronic world and bring their patients with them. While EHRs are praised for their promise to increase efficiency and safety, it is still an open question how much of those benefits will be realized or when.

There is one clear threat to the fruition of EHRs’ potential for quality improvement: the inability of various EHR systems to share information with one another. This potential limitation is highlighted prominently in a new Congressional Budget Office (CBO) report Quality Initiatives Undertaken by the Veterans Health Administration (August 2009), principally authored by Allison Percy of CBO’s National Security Division.

The Veterans Health Administration (VHA) is the largest U.S. integrated health care system. With over 200,000 full-time-equivalent employees, each year it treats 5.1 million of its 8 million enrollees at 153 medical centers, 931 ambulatory care and outpatient clinics, 232 readjustment counseling and outreach centers, 134 nursing homes, and with 50 residential rehabilitation treatment programs and 108 comprehensive home-based care programs.