Welcome to EMR and HIPAA

From MSNBC:
Electronic health records don’t aid patient care – MSNBC (Reuters)

Electronic health records — touted by policymakers as a way to improve the quality of health care — failed to boost care delivered in routine doctor visits, U.S. researchers said on Monday. Of 17 measures of quality assessed, electronic health records made no difference in 14 measures, according to a study published in the Archives of Internal Medicine. The study by researchers at Stanford and Harvard Universities was based on a survey of 1.8 billion physician visits in 2003 and 2004. Electronic health records were used in 18% of them. In 2 areas, better quality was associated with electronic records, while worse quality was found in one area, they said. Many experts believe electronic records can help prevent costly medical mistakes, but few studies have evaluated whether the records actually improve the level of care when compared with paper records. “Our findings were a bit of a surprise. We did expect practices (with electronic medical records) would have better quality of care,” said Dr. Randall Stafford of Stanford University. “They really performed about the same,” he said in a telephone interview.

Who said that EMRs were about increasing patients’ care? Ok, that looks nice for government work and it’s a great theory about saving lives. However, most of the EMR sales presentations I’ve seen talk about the bottom line. Sure, if I can cover my bottom line, then it’s great if I can offer better care also. However, I would guess that for 90% of the people choosing an EMR 90% of the decision is about dollars and cents.

Granted were not looking at all the details of this study. It would be interesting to take a look at how they quantified quality of care. That sounds like a rather subjective measure to me. I’d also be very interested to see how long most of the doctors in the study had been using an EHR. I can certainly see how at the beginning of an EHR implementation the patient care could be less than with paper. It takes time to mold a system and to implement all of the features that make an EHR work efficiently. However, once implemented a whole new world of patient care comes into focus.

What an EMR can eventually do for you is more interesting and powerful than the immediate impact of implementing an EMR.