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Enough to Make You Sick: The Cost of Medical Paperwork

Enough to Make You Sick: The Cost of Medical Paperwork
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President Obama offered $27 billion to encourage all physicians to switch to computerized medical records by 2015 as part of his 2009 stimulus package. While it makes a lot of sense to digitize medical records, progress has been slow. The cost of upgrading equipment can be around $40,000, as Medill on the Hill points out, a hefty sum for a small practice with a few or only one doctor. Critics cite fears of privacy (understandable in light of numerous recent reports about organizations like the CIA having their sites hacked into) and question if digital medical records will make any difference in patient care.

But one look at the wall of color-coded file folders in the average doctor’s office can leave a patient to wonder, how in the world are they going to dig out my file from so many? Digital medical records can also significantly lower health care costs. One reason health care costs so much is because we spend about $400 billion in paperwork and administrative costs. Digital medical records could help to defray these significantly.

As noted in the Medill on the Hill article, the US continues to drag its feet to switch to digital records because the process of switching is laborious and time-consuming.

In 2008 only four percent of physicians used electronic medical records that could be described as “meaningful,” according to a national survey in the New England Journal of Medicine. And according to a study published in Health Affairs in 2010, only two percent of U.S. hospitals reported having electronic medical records that meet the government’s criteria.

[Tim Huerta, assistant professor of Health Organization Management at Texas Tech University in Lubbock, Texas] said doctors may resist adopting the technology because it consumes a facility’s manpower, time and money. Doctors may have to pay to train employees how to operate the system, or spend the time or money to learn themselves. Meantime, the digitization of hundreds of thousands of paper medical records could take years. That switch could take up to 10 years for hospitals with high volumes of patient files, said Kim Bussie, the Director of Health Information Management at Howard University Hospital.

In addition, medical office staff needs training to use digital medical record systems. Keeping track of medical records has become a business and a profession in and of itself, as indicated by Huerta’s academic field being Health Organization Management; my own college has started a masters degree program in health records management.

As someone who has moved quite a bit over the past decade, I’m very much in favor of digital medical records. My son has always had some complicated medical issues as he’s autistic and needs to be followed closely by, among other doctors, a pediatric neurologist. As we’ve moved several times to find him the best possible school, we’ve had to switch doctors as many times, meaning that we’ve had to get medical records from an increasingly long list of doctors’ offices forwarded to the new doctor’s office. A digital record of all his medical history would be a huge help.

We do have our own xeroxed copy of the records from the St. Louis-area hospital where Charlie was born in 1997. We’d requested these years ago after hearing about a study linking pitocin, which is given to induce labor, to autism, and also to review the circumstances of Charlie’s birth, which happened after I was in labor for 21 1/2 hours. The records were certainly interesting to read but not that revealing. It was also simply hard to read the xerox-smudged words scrawled by busy hospital personnel; in some cases, words were illegible or abbreviated or cut off in the process of xeroxing.

A detailed graphic from Medical Transcription presents the “sick cost of medical paperwork” in quite glaring detail. Go to the next page of this post to see how billions in health care costs could be saved by going paperless for medical records.

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32 comments

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11:37PM PDT on Jul 31, 2011

Organic Tree Farms With Diverse Trees replace the existing tree farms. Nice headlines that has not been seen yet. Paper is still good for some people.

3:44PM PDT on Jul 31, 2011

Having lived in 2 countries that have digitized medical records, the US seems quite backward to me. When I returned to the US after many years overseas I brought a CD containing all of my medical records with me.

My sister is seriously ill with several diseases; she is frequently in the hospital and has several doctors. Just last week she requested all of her medical records from each of her doctors & her hospital. To her shock, she received huge stacks of paper records from each one, along with hefty bills (for the cost of photocopying each page). One particular bill was for almost $300 worth of photocopying..we have a very antiquated system indeed.

1:09AM PDT on Jul 31, 2011

Thank you for sharing this informative article.

11:02PM PDT on Jul 30, 2011

I understand that the initial $ cost of the transition to digital medical records is high, and that the cost in time and effort is also high. But isn't the cost, in $, time and effort of continuing with paper, sometimes illegible, records at least equally as high? I think it's time to change.

9:47PM PDT on Jul 30, 2011

As someone who worked for a major hospital system I'd like to highlight the "85% of administrative cost inefficiencies is from the US Private Healthcare system". For 10 years I worked for corporate trying to collect monies owed to us from insurance companies and I say 85% is lowballing it. We had to have trained billing specialists for every major insurance company. There is no universal explanation of benefits nor denial terminology between insurance companies. Many claims we had to appeal multiple times because the insurance companies are in the business of NOT paying out claims - that is how they make their profit. We could EASILY save enough in administrative inefficiencies by going single payor - enough to actually fund single payor for all. The insurance companies in the US are not set up in the consumer's best interest or in the provider's best interest, only in their own. Cut out the middleman big insurance and we'd save millions a year. In the US we pay more per person than every 1st world country, yet have lower average lifespans and higher infant mortality rates. We are the only 1st world country to not have a universal or single payor insurance system.

9:02PM PDT on Jul 30, 2011

First do no harm?

4:44PM PDT on Jul 30, 2011

When I became ill a few years ago at one point I had 17 doctors. Yes, you read that right. And when ever one of them needed to send a report to another one it never got there or the doctor could't find it or he or she didn't have time to look for it and read it. I soon started to see that I had to go back to the office and request a report be written up and I would make copies to pull out of my purse to hand to the doctor while I was examined. I would now suggest that everyone keep a binder of all reports and tests and CTs and all the rest. It's a drag but it's crazy not to. BTW, my GP now offers a special deal where he will give you a thumb drive and put everything on it. You have to pay a couple of hundred a month for this service. I don't have that kind of money to waste because of course the other doctors wouldn't put their reports on it. Last appointment I just told him to mail me what he wanted to tell the other doctor and I would bring it to him. He liked that. I asked him the year before about the usefulness of digital records and he quoted the same $40,000 price and the fear of losing the back up. Of course he could just make a hard copy just like he does now and a digital record to use with the other doctors. Eventually it will come to that. It's not rocket science any more and it would save a lot of time. They only are paid for 11 minutes of time by the insurance company. Now you know why you are getting the rush.

3:36PM PDT on Jul 30, 2011

Now, to add insult to illegibility, if you want personal copies of your medical records from the teaching hospital that is my only avenue to medical help it cost 10 cents a page to copy. They're raising it to 45 cents per page in September.

If a doctor requests them, the sending staff eats the cost. That's what I call doctor's priviledge.

2:22PM PDT on Jul 30, 2011

Another health INSURANCE issue having nothing to do with HEALTH CARE. The U.S. continues its slide to hell.

1:58PM PDT on Jul 30, 2011

Going digital sounds good on the surface...but what happens to the records when the system crashes?
A backup in paper seems to be the answer. But that means still having the wall of records. There needs to be a way to have the patients records not be lost do to life's unpredictable happenings.

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