Stanley Feld M.D.,FACP,MACE
The common impression is that physicians are resistant to the use of Electronic Medical Records. I believe there are important reasons adoption by physicians is slow.
Dr. Paul Feldan, one of three doctors in a New Jersey practice, said switching to electronic records did not make economic sense for his practice.
Dr. Blackford Middleton, a health technology expert at Partners Healthcare, a nonprofit medical group that includes Massachusetts General Hospital in Boston hit the nail on the head.
“We have a broken market for electronic health record adoption because the people who gain financially are not the people who pay.”
“To fix the market, Dr. Middleton recommends that the government play a role in providing incentives or subsidies to speed the use of computerized patient records in the United States.”
Wouldn’t it be simple if the government and healthcare insurance industry along with input from practicing physicians created the ideal electronic medical record? I believe adoption of an EMR would be rapid under certain circumstances.
I emphasize including practicing physicians of all specialties in creating an ideal EMR. If policy makers happen to ask for physician input it is usually from high profile academic physicians with little private practice experience. Academic physicians do not understand the practice problems of the private practice physicians.
The ideal EMR must contained strong patient privacy rules. Patients should have ownership of their EMR. Patients must have the exclusive decision making voice in how the information is distributed and used. This concept is totally opposite from the newly introduced HR6357 that is rapidly moving through the House of Representatives.
Private practices should be able download the EMR software for free. Customization of the generic EMR could be fitted to the physicians practice style. All measurable entries would be formatted as a relational database. Physicians would pay a minimal transaction fee for each click making the EMR affordable to physicians in all sized practices. All maintenance and upgrades would be web based and downloadable at no cost. (nomadic software as described in the Unfinished Revolution)
The saving to the government, the healthcare industry and the healthcare system would more than offset the cost of providing a uniform and upgradable electronic medical record to all the physicians in the U.S. The system must be easy to download and its use must be intuitive.
It is estimated that the healthcare system would save 5 billion dollars over five years alone if every physician used an e-prescription system. If would avoid many prescription errors due to handwriting misinterpretation.
For some reason government policy makers can not think about physicians needs. Someone must think innovatively. An EMR must be created that provides incentives to physicians to want to convert to an EMR. An EMR would not be used against physicians punitively but rather by physicians educationally.
Instead the government has just initiated a $150 million dollar long term pilot study that will fail because of its design.
“The government took a step in that direction last week, announcing a $150 million Medicare project that will offer doctors incentives ($58,000 over 5 years) to move from paper to electronic patient records. The program is intended to help up to 1,200 small practices in 12 cities and states make the conversion.’
I believe the government is making another costly complicated mistake. Winston Churchill was correct. “Americans eventually get it right after they try everything else.” The intent of the study is to test the impact of incentives on the adoption of electronic health records. Wouldn’t it be easier if someone used some common sense and asked private physicians and patients what they need rather than create a study that is destined to failure? The physician incentive is too small and the dangers to the patients and physicians too great.