Electronic Medical Records

Most people would agree that if 2005 was "the year" of anything, it was the year of the electronic medical record (EMR). This was the year health information technology finally went mainstream, in the public consciousness, following last year's announcement of a national strategy. David Brailer led the push to back EMRs and data exchange. Pilots were announced with some limited federal funding, and regional health information organizations (RHIO) proliferated. You could even argue that the National Health Information Network (NHIN) began to take shape with standards and certification schedules announced. 

In the real world of healthcare IT, vendors like Cerner and Epic had really successful years in terms of launches and deals with hospital systems (although Cerner's stock ran into some problems recently). GE finally dived into the HIT market in a semi-serious way with the purchase of IDX, although why they picked a smaller firm remains a little bit of a mystery. 

At this point, it seems that almost everybody agrees that electronic medical systems and adjuncts like computerized physician order entry (CPOE) systems are a good idea--in theory. The challenge remains how best to convince doctors in smaller practices, and the bulk of smaller hospitals which are not in giant systems, that the investment is worth the cost in money and trouble.

Amid the glowing reviews and the onslaught of buzzwords there were signs of a backlash, however. Studies appeared in major journals questioning the safety of CPOE systems. Physicians began complaining, in some cases quite loudly, that the whole thing is a waste of their time. Is it a period of natural resistance during a difficult transition or something more? Given that IT is the new panacea for curing healthcare, it's worth noting that one of the last cure-alls, managed care, was derailed by the same forces. We'll be watching this for a good while.

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