Making EMR Doctor-Friendly
In a speech in January 2009, President Obama said Electronic Medical Records (EMR) would "cut waste, eliminate red tape and reduce the need to repeat expensive medical tests. It just won't save billions of dollars and thousands of jobs — it will save lives by reducing the deadly but preventable medical errors that pervade our healthcare system."
Barrack Obama- President of USAIf only it were that simple! There is an almost wishful thinking that EMR is the cure for all evils that plague our healthcare. EMR is an important component of the administration’s healthcare strategy, but it is not an elixir by itself. We often discount the set-up time and investment it takes to get EMR systems up and running. Jack Cochran, an executive director of The Permanente Federation, which represents the national interests of Kaiser Permanente’s eight Medical Groups puts it succinctly: "There’s this incredible magical thinking about healthcare IT. Once you put it in, healthcare will be saved." He called EMRs "disruptive," but not for the near-term timeline. "When you put it in, it slows you down."
In the 600-page regulation published on Dec 30 by the Department of Health and Human Services (DHHS) one gets a glimpse of where the administration is trying to go—impose meaningful use requirement so as to coerce the healthcare industry in the long run towards the promised land of seamless data exchange and, hence, a seamless continuity of care when patients go from one doctor to another.
The ensuing backlash was predictable. Immediately after the regulation on meaningful use was published, provider groups raised a clamor. The Medical Group Management Association, which represents the small and medium-sized health practices described the rules as being “overly complex.” They feared that it would present “significant challenges” to small and medium practices.
The challenge it seems is on how to incentivize physicians to use EMR meaningfully. We must isolate the problems of adoption, implementation and data integration from the daily concerns of the physicians. Physicians must be able to continue to do what they do best—examine patients. The EMR company should bundle services so that doctors can examine and maintain notes the way they currently do (transcription + paper records); data entry into the EMR can be decoupled and married with transcription. In many ways, hospitals already do this for their doctors. This way doctors and patients can benefit from electronic records and it is not too much of an imposition on the doctors. Behavior change is very tough, almost impossible; many systems fail because they do not account for this reality. The EMR companies should make this workflow happen economically for their target market—small physician practice groups. I believe this is a winning formula. In fact, this was the approach taken by AthenaHealth in the medical billing area. Watch Jonathan Bush’s interview in the 2008 Health 2.0 symposium. Deerwalk will take this approach for competing with the Goliaths in the EMR market.