Thursday, July 19, 2007

Do EMRs make a Difference in the Quality of Care we provide?

A new study released by Brigham and Women's Hospital in Boston discerned no difference in performance outcomes in terms of whether or not physicians use EMRs. The researchers reviewed office visits to non-federally funded, community, walk-in physician practices across the country, using 17 ambulatory quality measures. The lead researcher, associate physician Jeffrey Linder, claims that other studies have revealed that many electronic health records aren't much more than an electronic replacement for paper charts, which suggests a mass underutilization of an EMR's true capabilities.

For more details, read the article in The Washington Post or review the study in the Archives of Internal Medicine (abstract only, unless registered).

Very interesting.

Jeffrey Linder interprets this as "mass underutilization of an EMR's true capabilities". I hope he was not referring to the physicians underutilizing the EMRs. This is certainly not true. The present day EMRs simply fall short, massively short, of what a good EMR could be.

I have no doubt that EMRs have great potential. Sadly, nowadays it is mainly mere potential. My hospital bought Centricity, the former Logician and now the EMR of GE. I was very disappointed by the striking difference between what an EMR could do and what it really is able to do in daily life. It only fulfills a fraction of the dream and it creates a whole lot of unnecessary work. The difference between your dream and reality is just too large.

Let's see: Does your EMR print out instruction leaflets personalized to the patient and her problem after the visit? Does it automatically fax a good looking, well worded, well formatted letter to the PCP after each visit? (My EMR does not even know the PCP of a patient, and even if it knew, it would not know the PCP's fax number and even if it knew, it could not fax it).

Does your EMR tie in and cooperate seamlessly with your website? Can patients book their appointments on your website and they show up in the EMR? Does your EMR send appointment reminders to your patients? Does your EMR produce automated lists of outstanding test results and missed appointments?

Does it generate lists for marketing such as patients and PCP birthdays; does it allow you to record the personal preferences of your patients, starting with how they would like to be addressed and numerous others?

Does it allow your patients to enter their medical histories online? Does it allow the patients to check in online or electronically in the reception area? Does your EMR interview the patient after arrival in your office - about her complaints, her symptoms, her concerns, her compliance with the usual screening tests?

Does your EMR send automated emails to your patients with follow up recommendations, more information on the topic at hand?

and on and on and on...

So, your EMR does that? No? Why am I not surprised?

So, why do you think your EMR should have any more abilities than just a paper chart converted into software?

Once EMR companies start asking for the needs of physicians and actually building programs that really help and really take over some work instead of causing more work, then we will see an increase in productivity!

And that will not happen anytime soon! Now all our poor colleagues feel under pressure to adopt some kind, any kind of EMR and are just wrapped up in choosing among the bad, the somewhat bad and the very bad EMRs that are commercially available.

Someone please come up with a smart EMR


Andrew said...

When TV first came out they just put plays on air. As the technology grows it will become more than just a paper chart on a screen. Hopefully some of us doctors can get rich on this one rather than letting everyone else in suits get it.

electronic medical records said...

Interesting post! According to research, The right electronic medical records software system can save a physician practice time and money, while also improving patient outcomes.That's the reason why many wants to have their own electronic medical records software system. Thanks for the post.