“If it’s [EMR investment and implementation] too hasty, you can create so many bad experiences that people say…’My data’s a mess and my patients are angry,'” Mr. Glaser said in a recent Wall Street Journal article on the possible wasted investment in EMR.
The scary thing is that John Glaser, chief information officer for Partners Healthcare, is probably right. I know that President Barack Obama wants to “wield technology’s wonders to raise health care’s quality and lower its costs.” I want to do that too. In fact, I think we’d all like for that to happen. Unfortunately, I think we have to seriously ask ourselves if the current electronic medical records offerings can raise health care’s quality and lower its costs.
I think there are two points that have been proven time and time again in implementing an electronic medical record in a doctor’s office.
Point 1: A Well Implemented EMR Yields Great Results – Hundreds (possibly thousands) of doctors can attest to how happy they are using an EMR. My personal finding is that the key to a successful EMR implementation is deeply related to how well a clinical practice is run before implementing an EMR. In fact, I believe an EMR will exacerbate any problems a clinic may have been experiencing pre-EMR. However, many clinics have shown that when done right there are tremendous benefits associated with an EMR.
Point 2: A Poorly Implemented EMR Causes More Harm Than Good – Blame it on the software. Blame it on the clinic. Blame it on the technology. Blame it on the health care culture. It’s probably a mixture of all of these things that has caused so many EMR implementations to fail. Regardless of the reason, all of these failed EMR implementations have shown the damage that can be done to a practice that fails in their implementation. Unhappy patients. Unhappy and frustrated doctors. Thousands of hours evaluating, learning, training, testing and implementing down the drain.
It’s no wonder that the New England Journal of Medicine found that only 4% of U.S. physicians were using a “fully functional” electronic health record system. The huge failure rate among physicians has created a fear in doctors that’s difficult to overcome. Sadly I think it might take a generation for doctors to overcome this bias.
The reality is that implementation of an EMR CAN increase health care’s quality and lower its costs. The problem is that most clinics haven’t yielded these promised benefits and most are living with failed EMR implementations. The huge numbers of failed implementations can not be ignored. Ignoring this will lead to even more failed implementations which could set the movement to digitizing patient records back years.
It’s not enough to poor money onto something without looking at and solving the reasons why so many people have failed in their implementation of electronic medical records.
I don’t want to give the impression that I’m not for investment in EMR and health care IT. I think that help is needed and could be beneficial to the future of health care in the US. I also really believe that EMR does open up a whole world of opportunities that we couldn’t consider without broad adoption of electronic medical records. However, I don’t think enough attention is being paid to understanding what factors are important to implementing an EMR successfully. By understanding these facets of implementation we can invest in electronic medical records that are actually being used and effective. Otherwise, we’re just lining the pockets of the EMR vendors without any benefits to health care or doctors.