EMR – The Untold Story

The last few years have been monumental for the healthcare in the US. With the introduction of the American Reinvestment and Recovery Act (ARRA), the government laid down the foundation for a new structure in order to improve healthcare delivery. EMRs have always been on the forefront, taking most of the fire. The government along with numerous healthcare professionals believes in the value of healthcare automation. However, EMRs are merely facilitators while physicians are still responsible for delivering quality healthcare.

Improved Healthcare with EMR

With an estimate of $6600 in healthcare costs being spent on an individual per annum, the effectiveness of the ARRA is instrumental in re-shaping the future of healthcare. “The government cannot afford any hiccups. We are all too far invested in this for it not to work.” comments a healthcare IT executive. “$6600? I don’t see it. Where is it going? You step out right now and look around you tell me if you can spot one individual that had 6600 spent on their health, one individual.” remarked a construction worker from New Jersey, during an independent survey.

The Meaningful Use requirements provide an effective road map for delivering quality healthcare. Its objective is to ensure that physicians learn how to effectively utilize EMRs and improve healthcare delivery. CMS introduced this exercise to help physicians realize what an EMR is capable of and how it adds to their care quality.

Likewise, the Affordable Care Act reforms have resulted in better EMR adoption rates. The government believes that there is at least $300 billion to be saved through standardization of health information technology. However, despite the expected benefits, there is still lot of skepticism surrounding EMRs. Many physicians believe that EMRs in fact do not add to practice productivity, but instead slow them down while increasing their overheads.

In a recent study by Danny McCormick and David Bor of Cambridge Health Alliance and Stephanie Woolhandler and David Himmelstein of CUNY School of Public Health indicated that EMRs may actually increase the frequency of tests ordered by physicians. More than 28,700 of patient visits and nearly 1,200 doctors were surveyed to determine the outcome. The study shows that physicians utilizing EHRs were 5% more likely to order imaging, rather than doctors who did not.

Danny McCormick believed that it was important to point out the contrast of the actual findings with the commonly constructed belief of EMRs decreasing health costs. However, he went on to state that it is attributable to the enhanced interoperability provided by EMRs that doctors can expect to get results faster and can easily view them on their screens.

Dr. David Blumenthal, who served as the national coordinator for Health IT at the Department of Health and Human Services from 2009-2011, pointed out that the study represents order of tests and not costs. He went on to state that the study does not take into account the overall impact of EHRs and accumulative healthcare costs. “The study doesn’t look at the benefits for quality of care at all. It’s possible that the use of tests by some of the doctors could have avoided other costs. This study has no way of assessing the overall implications of the behavior that it’s finding.”

Dr. Farzad Mostashari who is the National Coordinator for Health IT also voiced similar concerns in his reply. He believes that the study showed little evidence and did not consider the impact of EMRs in improving healthcare delivery. He also pointed out that due to the nature of the study it was not designed to answer questions about cost and quality. “Many other variables that could affect physician behavior could not be examined in this study, including having a sicker patient population, level of physician training, approach to defensive medicine, and, importantly, financial arrangements.”

The EMR is a technology that compels change and as long as it is resisted, its potential will remain muted.


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