Electronic Medical Record is a great buzzword. It is an idea that inspires awe and wonder in most people, regardless of their level of involvement with or knowledge of them. No matter who you are, unless you've had your head buried in the sand for the past few years, you've heard people about them. Politicians believe that electronic medical records will solve all of our countries medical problems. Doctors believe that electronic medical records mean they'll be able to get any info on a particular patient they need anytime they want. Nurses and MA's believe electronic medical records will mean no more sifting, carting, and trying to decipher old paper records, and everybody else believes the electronic medical record will finally push the lagging, aged medical industry into the 21st century.
But are these thoughts grounded in reality? It may be easy to be ready to accept the promises EMR's offer, with our nation spending over $1.68 trillion dollars on health care in 2003 (~15% of our gross domestic product), and costs not looking to come down anywhere in the near future. In his 2004 State of the Union address, President Bush cited a government report saying converting to EMR's could reduce health care costs by as much as 20% (or about $336 billion (!)). That's a big claim. But implementing an EMR system is not as easy as some may think. What if the costs of implementing a system on a wide (national) scale far outweigh the benefits? In the same speech, Bush called upon the medical community to implement some form of EMRs by 2014, then shortly after formed by executive order the Office of the National Coordinator of Health Information Technology and charged it with the development of a National Health Information Network. IBM then began work on a prototype for such a network, testing the interoperation of new standards with up to 200,000,000 anonymous and simulated patient records.
Like I said, everybody's talking about it. But is implementing such a system worth the time and money, despite the abject awfulness of current paper-based medical records.
A good place to start for information on electronic medical records is the Wikipedia section on it. One thing this wiki doesn't do a great job on is differentiating between an EMR and a CPR, or Computerized Patient Record. The main difference between an EMR and a CPR is that CPR is a term used usually to describe any "straightforward input or scanned data", as opposed to EMR, which constitute some kind of electronic distibuted database (all this, by the way, is according to the Medical Records Institute). As far as the scope of this article, we will be addressing EMR's, not CPR's.
In December 2005, hackers broke in to the Pentagon's medical records system and stole over 500,000 medical records of miliatry personnel and their families. The Pentagon later received an "F" in computer security from the House Government Reform subcommittee (a la WorldNetDaily). Hackers really can have a field-day with centralized data, or any type of data for that matter. Security is quite possibly everyone's biggest hangup on EMR's.
A study was done recently by Dr. Thomas Payne, M.D. at the University of Washington Medical Center concerning their update of EMR software to the new ORCA system (see his show). In his report, Dr. Payne lists as a major recurring theme the overwhelming complexity of such a system, and he details the amount of time and money spent training staff and fixing problems. While (reletively) easy to set up, ORCA became a bigger problem after the clinical staff started to use it. Even just reading his slides is eye-opening.
None of this is to say that EMRs are not worth the hassle. Nor is it to say that EMR systems are worth the hassle. It is not up to this article but the reader to decide that for himself. However, one thing is sure - like all technology,
Joe Fisher