Hospital exec: Too many EMR features tied to billing

In spite of their benefits, electronic medical records are flawed because so many of their features are tied to billing, not care, a cardiologist writes in a recent blog post published to

Ira Nash, senior vice president and executive director at North Shore-LIJ Medical Group, says that "nearly all of the things that doctors dislike about [EMRs] are 'features' designed to capture information needed for billing purposes. That is, they are all about documenting what we did to or for the patient, not about how the patient was doing."

Nash recalls an EMR he saw at one primary-care practice that was little more than a "medication list and an annotated problem list, with narrative added to each problem as needed."

Doctors (and EMRs), he adds, "are getting killed by the focus on process," when the focus, he says, should be on outcomes.

Focusing on caring for a population of people and being judged on appropriately adjusted outcomes could free doctors "from the stifling limitations of so many contemporary EMRs, while still enjoying the benefits they can provide for us and our patients," Nash writes.

Regardless of the problems, EMR adoption surged in 2013, Beth Israel Deaconess Medical Center CIO John Halamka writes in his own recent blog post.

Citing the 2013 Massachusetts Medical Society survey, Halamka says the adoption rate for Massachusetts physician practices of up to nine doctors was 75 percent. Larger practices, he says, showed adoption rates of 96 percent to 100 percent.

Meaningful use, Halamka says, "changed the EHR landscape."

In November, the Worcester Business Journal reported that some physician groups cite major benefits in patient-centered care from their meaningful use-compliant EMRs, such as mobile access to patient records, appointment scheduling and prescription renewals, and secure transmission of self-monitored blood pressure tests.

For more information:
- read Nash's post
- here's Halamka's post