Thanks everyone for your comments on my piece on EMRs earlier this week.
It's interesting to follow the ensuing discussion around the blogosphere, and there were a few comments that caught my eye. Like this one:
Most of these computerized record systems are not ready for prime time! They have major faults - it can often take significantly more time to complete an electronic record than to dictate the ...
Will it make "your life is hell for the next year?"
The answer is yes. It takes about 6-12 months for electronic records to fully manifest into the patient workflow, and for doctors to feel totally comfortable with the system.
It demonstrates how poorly designed many of the programs are, evidenced by the lack any kind of physician input in the user interface.
Dr. Wes points out how easy electronic records make it for lawyers to go fishing.
When it comes to electronic record terminology, I've assumed that electronic medical records (EMR) and electronic health records (EHR) were interchangeable.
A kind reader pointed out that they are not. Here's the subtle difference.
Provocative piece by hospitalist el jefe Bob Wachter. He laments how archaic most electronic records are, and I agree:
You'd think that medicine's conversion from paper to electronic records would solve many of these problems, but "“ to date "“ all it has done is create new-fangled electronic silos. In most EMRs, including the GE system we're using at UCSF, the notes are really just electronic incarnations ...
I haven't tried it yet, but will soon. I've read that its Java and ASP processing is unsurpassed, in anticipation of Google re-inventing the operating system that will work solely through its browser.
How does this apply to electronic medical records? If Google Chrome takes off, Canadian EMR suggests that the next generation of EMRs will be ASP-based and will make Windows-based systems obsolete.
Confused? Health IT guru John Halamka provides some clarity.
Dr. Wes: "The EMR contains the official transcript of your healthcare received. The EMR is the ultimate arbiter of healthcare delivery that is the undisputed king of records used in liability proceedings. As such, there is little incentive for physicians to maintain two sets of records. The Personal Health Record is just that: personal. It is NOT a health record. Sorry."
There's a reason why universal electronic records are nothing but a pipe dream:
The high cost of EMRs, combined with a small return on investment, is a main reason why physicians have been slow to adopt systems . . . While some EMR functions, such as billing and transcribing notes, financially benefit physicians, most of the return on investment accrues to health plans.
Not enough are, which is why so many of them fail.