Digital Medical Records - Not A Clear Winner?

Much has been said recently about the promise of portable, digital medical records, but there are two sides to the story.  For every authority that touts the efficiency, safety and cost benefits of an electronic medical record, there are others who say it's not as simple as the current administration and IT vendors would have you believe.

From BusinessWeek:

"Under the federal stimulus program enacted in February, hospitals can seek several million dollars apiece for tech purchases over the next five years. Individual physicians can receive up to $44,000. These carrots should encourage the proliferation of technology that will computerize physician orders, automate dispensing of drugs, and digitally store patient records. If providers participate broadly, those files are supposed to be accessible no matter where a consumer goes for treatment. President Barack Obama says the changes will improve care, eliminate errors, and eventually save billions of dollars a year. There's also a stick: The federal government will cut Medicare reimbursement for hospitals and medical practices that don't go electronic by 2015.

The incentives are working. R. Andrew Eckert, CEO of tech provider Eclipsys, says one client, a 250-bed hospital that shelved a software order in the fall after losing $50 million in the stock market, has reinstated the order. The move is "100% due to the stimulus," says Eckert (who won't name the hospital). Brandon Savage, chief medical officer at GE's health unit, says his company's technology will leapfrog the competition by not just replacing paper but also guiding doctors to the best, least-costly treatments."

But not everyone is sold.  It's Amercia - we like it that way: 

"That rare agreement, however, is obscuring the checkered history of computerized medical files and drowning out legitimate questions about their effectiveness. Cerner, based in Kansas City, Mo., and other industry leaders are pushing expensive systems with serious shortcomings, some doctors say. The high cost and questionable quality of products currently on the market are important reasons why barely 1 in 50 hospitals has a comprehensive electronic records system, according to a study published in March in the New England Journal of Medicine. Only 17% of physicians use any type of electronic records.

But so far there's little conclusive evidence that computerizing all of medicine will yield significant savings. And improvements to patient care may be modest. An analysis of four years of Medicare data published in March in the scholarly journal Health Affairs found only marginal improvement in patient safety due to electronic records—specifically, the avoidance of two infections a year at the average U.S. hospital. "Health IT's true value remains uncertain," wrote Stephen Parente and Jeffrey McCullough, researchers at the University of Minnesota.

Part of the problem stems from a fundamental tension. Info tech companies want to sell mass-produced software. But officials at large hospitals say such systems, once installed, require time-consuming and costly customization. The alterations often make it difficult for different hospitals and medical offices to share data—a key goal. Meantime, the health IT industry has successfully lobbied against government oversight.

"Most big health IT projects have been clear disasters," says Dr. David Kibbe, senior technology adviser to the American Academy of Family Physicians. "This [digital push] is a microcosm for health-care reform....Will the narrow special interests win out over the public good?"

What special interests you ask?  When in doubt, the cynics follow the money in D.C.  For my money, as a software firm employee, it's almost impossible to serve a market this big without some significant level of customization on a big customer basis, and as the article points out, that makes sharing data difficult.

And if we can't get a portable medical record, and it really doesn't drive safety, why would we do it?  Got to get to one standard and force it on people for the economies of scale to work.

Comments

[JayAndrews]

Some technology requires so much attention that a business owner may be worried that he or she is now employed by the new technology and not the other way around. Electronic medical record software works for businesses. it has very good standard and it will take little time to adapt to the new software and its working.

[AIDS symptoms]

This is true that electronicaly generated medical data is of very importance but it has to be systematicaly loaded and the system has to be validated,
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[Andy Stones]

You are right Aids Symptoms, anything which is not systematically managed has no value. The EMR has got some real potential, this would not only save time but the doctors could concentrate more on the patient rather than knowing their medical history.