Electronic Health Records Carry a High Price Tag

The electronic health records initiative mayrequire a price tag of >$200 billion initially tobuild and operate, according to a study reportedin the Annals of Internal Medicine (August 2,2005). Using current estimates, the health careindustry alone will cover <20% of the cost. Leadinvestigator Rainu Kaushal, MD, said the findingssuggest that "policy initiatives are needed if weare to close this gap."

As for who should pick up the difference, Dr.Kaushal does not believe that it should fall solelyon the government. "I don't see them as having tofoot the bill. They can create the incentives. Thenthe private sector can run with it," she said. Forexample, the federal government could increasereimbursements for physicians who use electronichealth records for their Medicare and Medicaidpatients. The reimbursement might motivatesmaller physician groups to make the costly investmentthat is often needed for computer systems.

The transition to electronic health records ispicking up speed, thanks to members of Congress,President George W. Bush, and the healthcare sector. The urgency prompted researchers toestimate how much it would cost.The researchersprojected that it would cost $156 million to buildthe system and $48 billion annually to operate it.

National Coordinator for Health InformationTechnology David Brailer, MD, PhD, said that thegovernment is aware of the hefty cost."We knowit's in the billions of dollars, perhaps in the tens ofbillions of dollars, and possibly even the hundredsof billions. But the principal question is not howmuch it is. It's how do we create incentives toinvolve the private sector and prevent the federalgovernment from financing it all. We want it to bemarket-driven," he said.