We've written recently about fears the public may have with EMRs, such as greater risk of identity theft and more government or insurance bureaucrat intrusion into the doctor-patient relationship. Others, including those of us in the healthcare industry, worry that the billions of dollars allocated to encourage EMR usage will not have the intended effect of reducing costs and improving the quality of care. Many such concerns have been stoked by media reports, so we're glad to see a story in the Wall Street Journal this week that examines the benefits and pitfalls of EMRs in an even-handed manner. You'll recognize many of the names.
Harvard Medical School internist and entrepreneur Dr. Rushika Fernandopulle says that many EMRs are designed to improve coding and maximize reimbursements, often at the expense of clinician functionality. "When you're trying to read the notes of your colleague [in an EMR], it's almost impossible to figure out what happened to the patient," Fernandopulle tells the Journal. "You have to read through two pages of all this junk that's put in to increase billing."
HIMSS CEO H. Stephen Lieber disagrees with this assessment. "I just don't believe that," he says. "[EMRs] are primarily designed for improving clinical outcomes, and a second benefit is that they improve administrative efficiencies." Lieber says that the perception that EMRs are made more for billing stems from general physician resistance to change. He also acknowledges that some systems are more prone to glitches than others.
It's important to note, the Journal says, that cultures differ across healthcare organizations, so it's important to be able to customize an EMR. Reluctance to do so was a primary reason why physicians at Cedars-Sinai Medical Center revolted against a clunky CPOE implementation in 2002. "When confronted with long lists of options, if people are pressed for time or they don't understand the difference between the options, they might pick the wrong option," explains Cedars CMO Dr. Michael Langberg.
- read this Wall Street Journal story