Electronic Medical Records – end all, be all?

Safety, cost, efficiency….all stated reasons why we’re switching to electronic medical records (EMR) in healthcare.  Are these benefits being realized?

 

 

Safety and medical errors, always a concern of hospitals and physicians, has come front and center since 1999 when the Institute of Medicine released statistics that 98,000 deaths were due to preventable medical errors.  That study was conducted 14 years ago and even though I searched and searched with various keywords on the internet, I couldn’t find a more recent figure to determine whether we’ve made any progress. But clearly, safety is something we should all be striving for and hopefully EMR’s will help to that end. Simple ways EMR’s can help is by having legible documentation of exams and lab results, allowing healthcare professionals to cull more accurate data and therefore make more accurate decisions based on it.  So it would make sense that EMR’s can contribute to safety improvements but as I mentioned before, based on the lack of updated statistics since 1999, I can’t confirm that assumption.

 

But does it save money? A recent New York Times article discusses a 2013 RAND Corporation review of a previous 2005 RAND Corporation study.  The RAND Corporation, a research firm, did a study in 2005 stating that the adoption of EMR’s would save $81 billion annually. And then a follow up study 8 years later in 2013 says those figures were overstated. The rosy figures presented back in 2005 shouldn’t be surprising – the study performed by RAND at the behest of (read – “paid for by”) General Electric and Cerner Corporation…both companies that develop electronic medical records!  Just to drive home my point, I’ll say it a different way: the two companies that develop and sell EMR’s to various medical institutions paid a research firm to do a study that showed how great and cost-saving EMR’s could be! As an aside, RAND Corporation’s Mission statement on their website is “To help improve policy and decisionmaking through research and analysis” and their Core Values are “Quality and objectivity”. Pretty laughable. But if you’re a stockholder for the Cerner Corporation, your revenue tripled since that 2005 study. So good for you.

 

As for efficiency, EMR’s provide more sharing of patient records between doctors and hospitals so it’s easier for everyone to be on the same page for a particular patient’s care.  EMR’s are wonderful in that respect – sharing relevant information for potentially safer and less redundant care.  With less redundancy, aside from achieving efficiency, you could also reduce costs.

 

While I’m not convinced that EMR’s achieve what they set out to do – safety, cost savings, efficiency  – I do believe that EMR’s are the way to go. Even if they don’t save as much money as expected (they cost more because of the extensive customer support/information technology services that a hospital or medical practice must maintain), there is great comfort in knowing what other doctors and facilities have done in regards to a particular patient so that you have a thorough knowledge of their medical history and don’t repeat unnecessary tests.

 

If not EMR’s, how do we improve safety?  The most effective way to improve safety requires personal responsibility, not a quick fix from the Federal government. Nothing will be as effective as having family members at the patient’s bedside at all times while in the hospital. Sure this sounds impossible to do if everyone has a job, but unfortunately there’s no way around it. Family members must take shifts or get a nurse’s aid or sitter. If you do not have a person who has a vested interest in that patient’s well being all of the time, things will fall through the cracks. And I want to be very clear, the nurses providing care do have a vested interest in taking care of a patient – they love their job – but they have 10 other patients to care for and can’t be there all of the time.

 

While some of the purported benefits of EMR may ultimately be disproven, it will undoubtedly improve the sharing of necessary information and it is unquestionably here to stay. So jump on board!

 

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