As medicine moves forward in its most technologically advanced era yet, we continue to struggle with basic concepts such as record keeping. The medical record is vital to the care of the patient. It tells the story of each patient’s journey through the medical system. The idea of centralizing all pertinent medical information is, in theory, a step in the right direction. In utopia, there would be one medical record for each and every patient that could be accessed by any healthcare provider on the planet at a moments notice. However, in practice, this is a monumental task. Earlier this week, the New York Times published a special section on The Digital Physician. As part of the feature, the current state of the Electronic Medical Record (EMR) was examined.
The Federal government has mandated the implementation of EMR in order for providers to be paid at the highest allowable rates and receive certain incentive pay for complying with EMR. Terms such as “meaningful use” have been coined by legislators in Washington, DC. Certainly, a great deal of money has been spent by both the US government as well as individual providers to develop EMR and implement electronic records by predetermined government deadlines. EMR has the potential to provide increased patient safety and significant cost savings if developed properly. However, current EMR systems are not really ready for “prime time” There is no real data out there that has demonstrated improved outcomes with EMR use–it is interesting that Medicare refuses to reimburse for unproven therapies but the Federal government will mandate EMR implementation without long term outcomes data. Only recently are studies emerging to give us some idea of the impact of EMR on patient outcomes. I think that there is a great deal of work to be done in order for EMR to have the desired impacts on safety, communication and healthcare cost containment.