B-240642 January 22,199l The Honorable John Glenn Chairman, Committee on Governmental Affairs United States Senate Dear Mr. Chairman: In response to your request of December 4,1990, we &e reporting to you the results of our review of automated medical records. The report discusses the potential benefits that automation could make to the quality of patient care and the. factors that impede its use. We are making recommendations to the Secretary of Health and Human Services to support automated medical records as part of the Department’ mandate to conduct research on s outcomes of health care services. As agreed with your office, unless you publicly announce the contents of this report earlier, we plan no further distribution of it until 30 days from the date of this letter. At that time we will send copies to the Secretary of Health and Human Services; the Director, Office of Management and Budget; appropriate congressional committees; and other interested parties. This work was performed under the direction of Frank Reilly, Director, Human Resources Information Systems, who can be reached at (202) 275-3462 if you or your staff have any questions. Other major contributors are listed in appendix II. Sincerely yours, E j
Ralph V. Carlone Assistant Comptroller General
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While the nation spends more than half a trillion dollars a year on health care, the use of automation in the health care industry lags behind other industries. Many health care organizations are currently planning or impIementing large-scale automated information systems, but no organization has fully automated one of the most critical types of information, patient medical records. The patient medical record provides a chronology of a patient’ medical history, including symptoms, s d’ agnoses, and treatments. At present, most medical organizations keep t h ese records in manual, paper-intensive systems, which, when compared to automated systems used by the banking and airlines industries, are often slow in retrieving and transferring information, are labor intensive, and require huge amounts of storage space. Because of the Committee’ continuing interest in efforts to improve the s provision of medical care, the Chairman, Senate Committee on Govemmental Affairs, asked GAOto report to him on its review of automated medical records. GAO'Sobjectives in this study were to identify the (1) benefits of automating patient records and (2) factors that impede automation. In September 1989 the National Academy of Sciences’Institute of Medicine began a study of automated medical record systems, noting that patient medical record-keeping has changed little over the last two decades. Although hospitals have had automated financial data for some time, they have been slow in using automation to maintain patient medical data. No hospital has yet automated all aspects of a patient’ s medical record such as laboratory services, medical diagnoses, treatment pIans, and treatment outcomes. A 1990 survey conducted by a private consulting fin-n found that, although hospital expenditures for automation increased from $1 billion in 1979 to over $3.9 billion at the end of 1989, the overwhelming portion of these funds had been directed to financial activities. The Departments of Defense and Veterans Affairs are currentIy developing automated information systems for the broad support of medical care. These systems, which will provide support for both outpatient and inpatient services, are intended to replace manual systems and provide physicians with immediate access to data in patient medical records obtained from such departments as laboratory, pharmacy, and radiology. When complete, these efforts will provide automated information services to more medical facilities than any other hospital information system.
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