The difference between the projected cost savings and the reality of the situation stems from the fact that the EHR technologies implemented to date have not been designed to save money or improve patient care, says Leonard D'Avolio, associate center director of Biomedical Informatics at the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC). Instead, EHRs are used to document individual patients' conditions, pass this information among clinicians treating those patients, justify financial reimbursement and serve as the legal records of events.

　　This is because, if a health care facility has $1 million to spend, its managers are more likely to spend it on an expensive piece of lab equipment than on information technology, D'Avolio says, adding that the investment on lab equipment can be made up by charging patients access to it as a billable service. This is not the case for IT. Also, computers and networks used throughout hospitals and health care facilities are disconnected and often manufactured by different vendors without a standardized way of communicating. "Medical data is difficult to standardize because caring for patients is a complex process," he says. "We need to find some way of reaching across not just departments but entire hospitals. If you can't measure something, you can't improve it, and without access to this data, you can't measure it."

　　To qualify for a piece of the $19 billion being offered through the American Recovery and Reinvestment Act (ARRA), healthcare facilities will have to justify the significance of their IT investments to ensure they are "meaningful users" of EHRs. The Department of Health and Human Services has yet to define what it considers meaningful use

　　Aggregating info to create knowledge

　　Ideally, in addition to providing doctors with basic information about their patients, databases of vital signs, images, laboratory values, medications, diseases, interventions, and patient demographic information could be mined for new knowledge, D'Avolio says. "With just a few of these databases networked together, the power to improve health care increases exponentially," D'Avolio suggested. "All that is missing is the collective realization that better health care requires access to better information—not automation of the status quo." Down the road, the addition of genomic information, environmental factors and family history to these databases will enable clinicians to begin to realize the potential of personalized medicine, he added.

　　1. In America, it is slow to adopt information technology because —————.

　　A) the funds invested by the government is not enough in the past

　　B) EHRs have received less attention of the public in the past

　　C) whether it will be useful to doctors or not is doubtful

　　D) UPMC knows how difficult it is to digitize the hospital

　　2. The University of Pittsburgh Medical Center (UPMC) —————.

　　A) is the first medical center to adopt information technology

　　B) satisfy the requirement of the government on information technology

　　C) spent less money on information technology than it was estimated

　　D) attempted to created a universal EHR system, but met some difficulties

　　3. The health care network’s IT systems require a lot of effort to ensure it can communicate with one another mainly because —————..

　　A) the integration among different system is largely up to the IT staff

　　B) UPMC is like many other health care organizations in the United States

　　C) UPMC makes EHR systems look easy

　　D) UMPC began digitizing some of its records in 1996

　　4. The success of the EHR program is decided by —————..

　　A) the fact whether the information technology is available or not

　　B) the fact how well the doctors are trained to use the information technology

　　C) not only the presence of the technology but the doctor’s training on technology

　　D) the fact whether physicians can see the benefits of using EHR systems