A buddy of mine, Bob Burns at 5th Quadrant, sent me a couple of links questioning the clinical effectiveness of EMRs; the links were just adding to several others reports that I’ve seen recently. I’m not sure I agree with all the findings, but the direction in which the winds are blowing is clear: be wary of EMRs that promise better clinical outcomes.
- Electronic Health Record Use and the Quality of Ambulatory Care in the United States (from the Archives of Internal Medicine).
- Electronic Records Fail To Enhance Care, Study Finds (from iHealthBeat).
Oliver
I think the second one was picked up by Yahoo News and linked to from the main page, just below the headlines yesterday (in the scrolling ticker thing).
Although I am not in the EHR business I was sorry to see that.
From the second article:
“The study was based on a survey of 1.8 billion physician visits in 2003 and 2004, 18% of which used EHRs.”
2003 and 2004? Aren’t we in 07? I presume EHRs have improved a lot since then?
EMR Medical Software Guy
There are many outstanding electronic medical record systems on the market, and many of these systems have the POTENTIAL to materially improve patient outcomes, but technology by itself cannot and will not fix everything. Transformational improvement in ambulatory quality of care requires transformational changes to the way ambulatory care physicians practice medicine. Said another way, the system needs to be fixed, and it’s difficult to fix the system without a judicious application of information technology.
This is hard work, and unfortunately, the fruits of this labor are unfairly enjoyed – physicians must work hard to transform how their system is structured, and payers disproportionately reap the benefits. (That’s not to say physicians don’t reap any of the benefits!)
I’ve found that some physicians mislead themselves (or perhaps are misled by others) to believe that dramatic change is one switch flip away; that setting up an EMR system will fix everything. Many other physicians recognize such systems are one ingredient in a larger recipe for change, and some of these ingredients consist of “old fashioned” changes to how workflow is performed in the office. Of course, our payment system needs to change, too. To be sure, I’ve seen physicians dramatically improve their care (not to mention reduce costs and maximize time) by making the most of their software solution.
It has been my experience that the very best EMR is only as good as what the user does with it. Many systems will reinforce good care practices, and some will help physicians avoid practicing poor care, but a lot of users simply rely on the software to automate bad habits. It just so happens that ALL software systems can do this if the user wants it to. lol
Physician Advice: If a software vendor (or any type of vendor, for that matter) promises that their solution will single-handedly solve all your problems with little or no effort on your part, run in the other direction. I wish things were so simple. The right software with the right user can really make a difference, but it will not by itself solve all of your issues.
EMR Software Guy
http://www.electronic-medical-record.blogspot.com
Trey
Exactly.
We emphasize that improving quality requires work on the part of the physician and staff – no matter what product they choose (or chose). An EHR system can make it somewhat easier with prompts and reports, but it won’t do it for the care givers.
Paul
Quite right. From my experience many EMR systems are being used as electronic document storage systems rather than what they were designed for which is to organize patient medical data. In trying to market my product, the EMRy STICK, I have found the benefits of auto populating a PHR with EMR information are reduced significantly when practices only scan documents rather than enter the medical data.
I created my product, a personal health record, so patients would not need to enter their medical records manually and have come to find out that doctors need the same capability. Many doctors receive FAXs rather than an electronic transfer of data. They then scan these into their EMR System. There needs to be better interoperability between medical facilities.
As I was recently told, paper medical records are less than useless. Scanned paper medical records are less than useless and expensive.
My two cents
Paul