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Electronic Medical Records – The 3% Solution with Few Improved Outcomes

March 25, 2012

The evidence continues to build on how little electronic medical records (EMRs) contribute to healthcare.

  • A Cochrane review of on-screen computer reminders found that physicians’ practices (process measures, medication ordering, vaccinations, and test ordering) improved by 4% and patients’ surrogate health measures (blood pressure or cholesterol levels) improved by 3%.
  • Another review of physician behavior change found computer reminders improved physicians’ adherence to care processes by 4%.
  • A recent randomized controlled trial of proactive EMR searching with messages sent to primary care physicians found that the percentage of patients recognized as being at increased cardiovascular risk ranged between 1.0% to 2.8% in different patient types (each patient type group had intervention and control arms). There was no difference in the cardiovascular event rate between the intervention and control groups.

Newt Gingrich recently commented on one of the news chat shows that social engineering was wrong on either the right or left. However, I distinctly remember him pushing for government interventions to force the healthcare industry to more widely adopt EMRs. Little did he realize he was helping waste $300 billion in nearly useless medical resources (or whatever the final total will be). If EMRs were such a naturally good idea, they would have been adopted widely without interventions from outsiders – think of i-Phones and i-Pads.

I realize the cow is out of the barn on EMRs, but it’s not too late to restore some sanity to our system. The bureaucrats/policy makers should accept that EMRs don’t solve much of anything, especially healthcare costs. Quality measures should not insist on EMR-based outcomes.

Policy makers should remind themselves that the most important resource to deliver better care at a lower cost is not the electronic gadgets in an office or hospital, it’s the squishy stuff between the family physicians’ ears.

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3 Responses to Electronic Medical Records – The 3% Solution with Few Improved Outcomes

  1. Tracie Updike MD on March 25, 2012 at 10:36 pm

    And what makes the emrs worse: is meaningful use!! What a joke? The amount of money I have spent is not funny! I got the first 1800.00 but I am not sure iif I am going to go forward. Especially since I consider it money I paid in to the federal government.
    But I like my emr and I have had it for seven years but it was my own decision.

  2. Robert Watkins on March 26, 2012 at 7:15 am

    And no one’s behavior in this debacle has been less honorable than that of the AAFP, who, rather than making evidence-based recommendations that would benefit patients and physicians, chose to spend the last decade working as an unpaid PR agency for the for-profit EMR industry.

  3. S Silverstein on April 2, 2012 at 6:38 pm

    See “Reading list on health IT” at http://hcrenewal.blogspot.com/2011/02/updated-reading-list-on-health-it.html , and “Common Examples of Health IT Difficulties” at http://www.ischool.drexel.edu/faculty/ssilverstein/cases .

    I believe we need to reframe the debate from “Luddite docs vs. IT modernists” to the more correct “pragmatic docs vs. IT hyper-entuhisiasts” who I term “Ddulites” (Luddite with first four characters backwards.)

    See “Reframing the debate” at http://hcrenewal.blogspot.com/2012/03/doctors-and-ehrs-reframing-modernists-v.html , and also see http://hcrenewal.blogspot.com/2012/02/health-it-ddulites-and-disregard-for.html

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