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Major healthcare organizations like Kaiser Permanente Group, the Mayo Clinic
and other centers in the US have spent billions of dollars to convert to EHRs.
Medicare and some employers are paying incentives to medical providers that can
achieve better effi ciency and patient care through improved information manage-
ment. Smaller medical practices, where majority of the US patients are treated,
lagged behind in adoption of EHRs because of the high initial costs involved and the
need for support and training. As of 2008, only 13 % of US physicians had basic EHR
system and 4 % reported having an extensive, fully functional EHR system
(DesRoches et al. 2008 ). Another survey found that only 1.5 % of US hospitals had a
comprehensive EHR system (i.e. present in all clinical units), and an additional 7.6 %
had a basic system (i.e. present in at least one clinical unit). Computerized provider-
order entry for medications had been implemented in only 17 % of hospitals (Jha
et al. 2009 ). Larger hospitals, those located in urban areas, and teaching hospitals are
more likely to have electronic-records systems. The adoption of HER has increased
since 2008. Taconic Health Information Network in New York State introduced an
affordable and practical system for computerization of patient records in small medi-
cal practices. This led to reduction of medication errors and redundant procedures
while improving diagnostic accuracy and facilitating electronic prescribing.
In 2009, the US Congress provided the health care community with a transfor-
mational opportunity to break through the barriers to progress. The Health
Information Technology for Economic and Clinical Health Act (HITECH) autho-
rized incentive payments through Medicare and Medicaid to clinicians and hospi-
tals when they use EHRs privately and securely to achieve specifi ed improvements
in care delivery. Through HITECH, the US Federal Government has committed
unprecedented resources to supporting the adoption and use of EHRs. The DHHS is
committed to the support, collaboration, and ongoing learning that will mark the
progress toward electronically connected, information-driven medical care
(Blumenthal and Tavenner 2010 ).
Janssen Diagnostics’ AVIGA™, a subscription EHR that harnesses and trans-
forms data into knowledge with its analytical power, boosts the health information
system. Along with AVIGA REPORTER™, a reporting and research tool designed
for use with another EHR, clinicians and healthcare professionals can assimilate the
information needed to make timely, informed treatment decisions for their patients.
Cost of EHR and Savings on Healthcare Expenses in the US
RAND Corporation researchers projected in 2005 that rapid adoption of EHR could
save the US > $81 billion annually. Seven years later adoption of HER had failed to
produce the hoped-for savings in health care costs and has mixed results, at best, in
improving effi ciency and patient care, according to a new analysis by RAND
( Kellermann and Jones 2013 ). Health care expenditures in the US have grown by
$800 billion. The disappointing performance of EHR can be largely attributed to
several factors: sluggish adoption of EHR systems, coupled with the choice of sys-
tems that are neither interoperable nor easy to use; and the failure of health care
20 Development of Personalized Medicine