Comments on: The billions spent on electronic health records, and why there’s no way to know if EHRs will save money

By: R Watkins

R Watkins — Wed, 02 Dec 2009 18:34:03 +0000

The financial data that has so far come out of the Transformed Project has been very spotty and inconsistent.

The project evaluators are on record saying that participation was financially stressful for many practices, even with the enormous amount of free assistance they were given. There have been vague references to “increased revenues,” but nothing specific about overhead, physician hours worked, etc. One physician participant stated (I can’t find the reference right now) that at the end of the two year project, not one insurance company was paying her anything for all the extra services she was providing.

The patient registries were considered one of the most difficult features to implement, and many practices failed. Aside from a few demo projects, I am not aware of anyone who is getting paid for the trememdous amount of work that registries involve.

By: No TransforMed for Me

No TransforMed for Me — Wed, 02 Dec 2009 14:50:49 +0000

RE: Transformed Project

The clinic where my former doctor practices was part of the TransforMed Project. During the two years while the project was implemented, my doctor became unavailable without a two month wait. I was passed around to nine different providers, most of them NPs and PAs. My last visit, I was charged $290 to see a PA. In contrast, my new patient neuologist visit was $287. When I left the practice, my EMR was difficult for my new doctor to read with all the check boxes and lack of provider notes.

By: Tex Bryant

Tex Bryant — Wed, 02 Dec 2009 12:26:49 +0000

Most of the discussion on HIT in the primary care setting or otherwise focuses on EHR’s. I have seen very little discussions on registries. I do know that the American College of Family Physicians under its TransforMed project makes extensive use of these. From their website I gather that patient health has improved with them and there has been an average 14% increase in income per physician at TransforMed sites, although this cannot be explicitly stated as due to the use of registries.

By: othniel

othniel — Tue, 01 Dec 2009 14:14:21 +0000

EHR and EMR are not the same thing. Companies have been working on EMRs all across the country, but very few are piloting an EHR.

By: Michael Laccheo, MD

Michael Laccheo, MD — Mon, 30 Nov 2009 20:56:04 +0000

I’d just like to point out that while the author of this post has an interest in EMR’s given that Practice Fusion is an EMR, he clearly isn’t schilling for his company and provides a reasonable analysis of one aspect of thiis issue. I appreciate it.

By: jsmith

jsmith — Mon, 30 Nov 2009 20:54:12 +0000

The author is half right. EHRs almost certainly won’t save money. But he should be more skeptical about their ability to improve care.
There is no good evidence that they improve care much either. See the recent American Journal of Medicine article. A little better care maybe, but no good data on long-term important outcomes. And of course extrapolation is a fool’s game. Who can say what ripple effects EHRs might have, if widely adopted? If they demoralize primary care further, we will have shot ourselves in the foot with them. Let’s face facts: EHRs are simply a medical mania, a craze that has taken hold of decision makers who want desperately to believe that they are a panacea, even if there is no evidence to that effect. I don’t know whether EHRs will ever do much good for HC in this country. Neither does anyone else.