Most hospitals still use paper records, and why money alone won’t solve the electronic medical record problem

New numbers have recently come out, highlighting how low the adoption rate is for electronic medical records in hospitals.

As reported by MedPage Today, the study from the NEJM found that only 1.5 percent of hospitals surveyed had comprehensive electronic medical record systems. That’s a piss-poor adoption rate, and far lower than the dismal numbers in small office practices.

The reasons cited are no surprise to regular readers of the blog, and according to the survey, “some 30% said the return on investment was unclear, 45% pointed to maintenance costs, about 30% did not have adequate information-technology staff, and about 35% worried about physician resistance.”

To the government’s credit, they are allocating some $19 billion to the problem. But, despite cost being a primary factor of digital adoption reluctance, I don’t think that money alone will solve the problem.

The larger issue is that the current generation of digital record systems, to put it bluntly, suck.

The accompanying perspective piece sums this fact up nicely, writing, “the current health record suppliers [are] offering pre-Internet era software “” costly and wedded to proprietary technology standards that make it difficult for customers to switch vendors and for outside programmers to make upgrades and improvements.”

I completely agree with the proposed solution to the problem, by “[encouraging] the development of an open software platform on which innovators could write electronic health record applications.”

For instance, imagine an open-source system that allows seamless installation of applets, such as those found in the iPhone or Facebook.

We’re so far away from that kind of technology, that simply pouring money into the what we currently have may actually impede the innovation needed to make digital medical records more usable.


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