Now Reading: Electronic Health Records’ Limited Successes Suggest More Targeted Uses

Provocative question #1: If a (fee for service) hospital’s livelihood is dependent on providing more care, how can any technology be expected to result in an outcome that less care is provided (such as reduced hospital days, reduced readmissions)?

Provocative question #2: Would patient and family access to the hospital record in real time result in downward pressure on the outcomes measured above?

(See @ReginaHolliday’s April 20, 2010 testimony to the Meaningful Use Workgroup, in Washington, DC, for an idea of what an activated family might be able to uncover and improve during an admission or prevent re-admission)

Informational question #1: Does anyone know of a hospital that grants real-time access to the full electronic record to patient and family during hospitalization?
Feel free to answer any / all of the above in the comments.


Great questions. The analysis needs to consider how pay mix and utilization would shift depending on the answers to the provocative and informational questions above. Less care (fewer care transactions with a certain pay mix and utilization profile) might actually translate into improved overall care and outcomes and achieve pay/utilization targets that would drive certain costs down and margins up. More admits or more procedures may generate more billings in a fee-based ecosystem – but not necessarily more margin, depending on the pay mix and utilization associated with the admits and procedures. Maybe you could get some revenue cycle people in the same room with the HIT and clinical people, close the door and have a candid discussion about how and where reducing admits/procedures, reducing hospital days/readmits might lead to better patient outcomes, happier care provider/patient relationships and better financial results.

Ted Eytan, MD