In the early 2000s, the Federal government with support from hospital groups pushed the agenda to create the miracle of electronic medical records. Though doctors resisted, the demand prevailed. Using the fear of not being paid, providers began to work to comply with the new agenda (and the government did offer to help defray the cost with some time limitations). So what happened next?
The major focus of the EMR was to provide quality health care, with medical records easily accessible to those involved in the treatment of a patient.
Enter private enterprise: Companies developed software to handle patient records offering cost savings, easily accessible and logical documents, documentation of information to support the claims processing, and general improved efficiency of patient care.
Did it work? Providers report that rather than looking at and interacting with their patients, they are now busy staring at a screen to check off all the required templates (to meet insurance company and government requirements) with emphasis on the “bullet points.” This activity does not add any elements of quality to care. As far as efficiency is concerned, most doctors say they are 25% less efficient and are seeing fewer patients as a result. Fewer patients also impact revenue, the life blood of the practice.
With the many different EMR software programs now being used, none of them will talk to the other, some are difficult and cumbersome to use and do not match what the provider thinks is relevant to medical care, but are slanted toward what insurance payers and data miners want. The resulting complications affecting practice are not encouraging for those interested in medicine as a career and are creating enough stress to force existing providers to quit for other careers.
Certainly it is clear than an EMR that serves patients and providers is needed. Every other industry relies heavily on computers for efficiency, but in medicine, the EMR has had the opposite effect.
The debacle is squarely on the shoulders of the government since no standards for the development of the software were really ever defined, thus the mixed bag of programs. Imagine if the same were true with word processors. Thousands of documents would be processed and executed but the receivers of them would be unable to read the document(s). Until standards are developed and proven to be an asset, the EMR just doesn’t work.