Article - July 28, 2008 - HULIQ

Most Doctors Aren’t Using Electronic Medical Records

By Stanley Feld

Why do physicians seem resistant to the use of Electronic Medical Records (EMRs)? The answer is there are at least three barriers to adoption of EMRs that healthcare policy wonks seem to ignore that must be cured.

The New York Times reported on a survey published in the New England Journal of Medicine that less than 9% of physician in small physician office practices use EMRs? The major barrier is these small physician practices cannot afford to buy them and do not know which EMR to buy.

here are different sized medical practice groups in the United States. However, more than 50% of physicians practice in groups of one to three physicians. The survey points out that the smaller the group the less likely they are to have an EMR.

“Dr. Paul Feldan, one of three doctors in a New Jersey practice, said switching to electronic records did not make economic sense.”

I have described the ideal electronic medical record. I have also emphasized that the patient should own the record. Its distribution should be exclusively in the hands of the patient. Technology exists to create a fabulous electronic medical record. The data generated could increase the quality of medical care and decrease medical errors. The result could be an enormous decrease in the costs to the healthcare system.

So why is the medical community slow to adopt the EMR? The government sponsored survey points to two contradictory conclusions.

The New England Journal of Medicine published survey found that doctors who use electronic health records say overwhelmingly that such records have helped improve the quality and timeliness of care.

Dr. Peter Masucci, a pediatrician in Massachusetts, said shifting to computerized records helped improve his patient care.

The meaning of the concept of quality medical care should be obvious but is complex. The judgment of quality medical care by a computer program is frequently wrong. This, in my opinion, is the major problem with the present Pay for Performance fad. It is an attempt at a judgment of quality that results in a punitive action against the doctor rather than being an educational experience for him or her.

Physicians in private practice have been slow to adopt EMR’s for at least three reasons.

1. They do not have the financial resources to spend $25,000 to $80,000 per physicians to purchase an EMR. The range of cost for an EMR implies differences in quality and capability of the various EMRs on the market. Many physicians have made investments in EMRs only to find them to be deficient in many areas. The initial investment does not include a yearly maintenance service contracts or updates. Many EMRs lack adequate software support. Physicians do not have the skill or want to devote the time to figure out the best deal.

2. A second reason is the lack of financial incentives to purchase an EMR. The EMR might help the healthcare insurance and government accumulate data about physician practices and patients care. It might save money for these stakeholders but there are no assurances that the saving will be passed on to either physicians or patients. The promise of the EMR is it should increase productivity and decrease practice overhead. Physicians should be able to decrease the number of full time employees. In most cases this does not happen.

Full story


Page Information

  • 3 months ago [history]
  • View page source
  • You're not logged in
  • No tags yet learn more

Wiki Information
Update to PBwiki 2.0

An entirely new PBwiki experience, including folders and easier editing.

Convert Now for Free | Learn more