November 20, 2012

Why electronic medical records (EMR) are not good for patients

EMR (Electronic Medical Records)  has finally passed the 50% adoption mark; yet "fully functional" usage is still in the teens.  So why is there an almost 4-fold discrepancy between “any EMR” and “fully functional EMR”?

Don’t get me wrong, EMRs (electronic medical records) are inevitable. Over the long-run they are almost certainly good for physicians, patients and the healthcare industry. However, their origin and the ulterior motives currently driving their adoption is sowing the seeds of their failure.

If EMRs are so great, why does the government have to essentially “bribe” physicians to adopt them through incentives such as the meaningful use incentive program?  Why is this so important to them that they didn’t even wait for the healthcare affordability act to implement this “incentive”? (They put it in the stimulus package after Obama had only been in office a few months.)

  Why EMR is a dirty word to doctors

One reason that incentives and threats of decreased payment are necessary for EMR adoption is that the industry and physicians have known for years that EMRs do not improve productivity and that it is highly questionable that EMRs lead to better patient outcomes.  So why is all this taxpayer debt being accrued by throwing borrowed money at the healthcare industry to drive EMR adoption, if the end users are so disenchanted?

As Jonathan Bush, the Founder-CEO of AthenaHealth (a major EMR supplier) famously said, “It’s healthcare information technology’s version of cash-for-clunkers,” and because it is actually all about control.

The goal of EMRs is to wrestle control of healthcare away from the doctor-patient relationship into the hands of third parties who can then implement their policies by simply removing a button or an option in the EMR.  If you can’t select a particular treatment option, for all intents and purposes the option doesn’t exist or the red tape to choose it is so painful that there is little incentive to “fight the system.”

For patients, this means that they will only be able to consume the healthcare that they “qualify” for or be forced to find another way to obtain the care that they want and need.  It is the second outcome that is the most intriguing, because as “shoppers,” patients will want to be informed and have choices as they take on more responsibility for the cost and quality of their own care.

For physicians … well, it isn’t hard to figure out where this is all heading.  EMRs are quickly becoming the instrument by which we are controlled and managed.  As an example, many organizations are already starting to restrict diagnostic testing and therapies via EMR.
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Having left the guidelines vague and largely written by a small group of industry insiders, most products have become a Tower of Babel with atrocious user interfaces and user experiences that … well, I don’t blame my fellow physicians for not wanting to use them. In addition to being expensive, they are complex, inefficient, and do not make physicians or their staff more productive.
Posted by Jill Fallon at November 20, 2012 6:11 PM | Permalink