Where Are We With EMR's?

One of the goals of the Obama adminstration is to put all medical records in a digital format. It's a noble goal, but one that has a long way to go.

For starters, many doctors are reluctant to spend upwards of $10,000 to go from paper to digital. They have huge overheads (malpractice insurance premiums, facility rental costs, equipment costs, disposal costs and labor -- nurses, receptionists, secretaries and billing clerks). The last thing they want to do is add to that, especially since they are unclear about the advantages. And the dirty little secret is that many doctors are not that computer-literate.

The other problem is that there is no standard yet for medical records. The point of electronic medical records (EMR's) is to become more efficient. A specialist should be able to e-mail a patient's records to the GP. A doctor should have access to the patient's records, even if the patient had been admitted to an out-of-state hospital, say, with a heart attack. If the patient were at a VA hospital, that's doable, from Maine to Hawaii. If the patient was taken to a regular hospital, good luck.

My son's pediatrician not only relies on EMRs, but encourages patients to take advantage of access. There's an annual tech fee of $25.00, but it's worth every penny. If we visit relatives in Florida and we need to double check on the dosage of Children's Tylenol that he recommends, we can access it from any computer or smart phone with a good browser.

If we are to make visible progress with EMR's, we need a consortium of government, insurance and tech firms to come up with standards for software that is both user-friendly and flexible. Standards change. Twenty-some odd years ago, Lotus ruled the world of spreadsheets. It interfaced with Quicken and other software. Excel was able to capture the market not just because it is easier to use, but because people could easily convert. That's the direction we need to take with EMR's.