EMR implementation — a saving grace or year of hell?

A friend of mine sent me this link – "Beware of the EMR ‘Ponzi scheme,’ warns physician leader" — earlier this week. The article starts off by saying:

Healthcare IT does not necessarily make life easier for
primary care physicians, says a leader in the movement to make medicine
more efficient and patient-centered.

"When you put an EMR into a primary care practice, your life is hell for the next year," said L.Gordon Moore, MD.

"EMR vendors aren’t really giving us what we need. We have to make a
distinction between a robust EMR with decision support tools, and one
that is just being marketed as a way to improve coding. And we really
need to get out of the E&M coding game."

Yikes. I’ve been in the health care IT market for a while and that’s
probably one of the strongest anti-EMR statements I’ve seen publicly.

I know many readers are physicians — how many of you concur with Dr. Moore?

Shahid Shah is a health care consultant, specializing in IT. He blogs regularly at The Healthcare IT Guy.

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8 replies »

  1. EMR has cause our practice to drastically slow down. The amount of tedious clicks the doctor has to go through to get his work done is overwhelming. The idea of EMR is very different from the reality of it because in the end it is NOT making out work mor eefficient. It is burning the physicians out. Very disheartening to say the LEAST.

  2. Here is a new website you might want to consider:
    Biomedical Device integration Tech Cormer
    “An archive of technical documents, protocols, standards and procedures useful for clinical engineers and IT professionals involved in biomedical device integration and connectivity to electronic medical records (EMR)”

  3. All comments about EMR mentioned above are obviously true.
    However, EMR system including: software, implementation, hardware component, storage, etc. etc. truly depends upon the following:
    • Standing of the company, who developed the product,
    • IT company who is implementing and supporting the product,
    • Who are end users.
    A mental determination to implement the system is required even before someone thinks about EMR. Even in a doubtful situation of this determination, none of the system works. All system have pluses and minus, Each IT company have pluses and minus, and same case is true for each user.
    There are few EMR available that take care of all aspects mentioned in these postings. It is just a matter of finding it.
    We are IT professionals in healthcare industry for the past 20+ years providing Practice Management Systems and now EMR system. Our system is developed by a physician and owned by one of top 18 Fortune 100 companies. We are proud to say we do not have client who are complaining those issues mentioned in this blog.
    Any one interested in finding more about this robust system, send me e-mail at sales@admcsi.com

  4. I agree and fully support the statement made that currently EMR implementations are hell.
    It starts with the initial installation which is costly and time consuming. Hardware is necessary but not the right hardware is chosen. It all comes from the way the EMR software was designed. Most EMR software systems out there are client-server based or web based. In the client server case the underlying technology is usually Microsoft which means that cost needs to be added to the overall implementation. In a sense a clinic needs to incur cost before the EMR vendor can charge their set amount for their product usage.
    Another identified shortcoming is the lack of support or better said the quality of the support services added.
    When choosing technology to build an EMR if the overall picture is kept in mind, deployment costs, support costs can be easily minimized by offering hosted solutions that utilize the adequate technology (security, speed, etc).
    The fact is that majority of EMR packages are built on obsolete technology that is simply not scalable.
    Now why do I make all these statements? It is simply because I (MDIT – the company which myself and 3 other colleagues created) developed a product that considered all these shortcomings and I would like to further asses its functionality against the market needs.
    If anyone is interested please contact me at alex.marcu@gmail.com

  5. I firmly believe as the gentleman has stated above. Current versions of EMR’s ar awkward, diorganized, difficult to use and unsuitable for practice as we have it today. Its really not surprising, medical information have defied computerization for the last 20 years. It’s very likly that the right system hasn’t even been examined yet.
    Problems that the current systems tend fail on are rational, organized physician entry and recovery (the idea of the system is to unload the menial burdens from the physician can do what he is trained for. Data storage in a flexible secure way is another problem. The standardized billing form presents the requirements of data from the patient, the payor, insurance companies, problems, procedures, codes and costs and there are many possible relations to each field.
    I mention the billing not to say that printing a clean billing form is a priority but to emphasize that the data is extremely complex. I want a system that will make it impossible for me to make a mistake whether it is from miskeying aor lack of knowledge. I want to know drugs of choice. I want a program that can look back in the problem list and note a potentially related problem from earlier.
    We’re talking about trillions of dollars of saving with a development effort probably in the low millions if that. We’re also talking about a goverment that wastes 3 billion dollars that can be out performed by 1995 technology.
    Hello…..! is anyone listening?

  6. My company is doing something that may be of interest to this group. We’re hosting a town hall meeting about healthcare reform and electronic health records. The meeting is scheduled for Dec. 1 at Seattle’s Town Hall. For more information go to healthcaretownhall.com.

  7. That’s been our experience. We haven’t been using it for a full two months yet, but it has slowed us down immensely (or at least you can see the same number of patient in a day, if you are willing to dedicate another 10-20 hours per WEEK to documentation) and it doesn’t offer much beyond coding. Hell, it doesn’t even really support coding all that well … there’s no way to glance at the day’s list of patients to see that you’ve submitted the charges and generated the damn “reports”. At least with my paper billing sheets, even though I charged more 99213s, I could tell when I was done with the chart. We give cash patients a 15% discount, if they pay at the time of service, but we still haven’t figured out how to do that through the new tools.
    Decision tools? The EMR we bought barely supports keeping track of health maintenance issues like mammograms and colonoscopy. (It keeps reminding me that people whose colos I have patiently entered — and it does require patience to enter a damn date — haven’t had flex sigs.) I can’t easily leaf back through previous visits’ progress notes! The drug contraindication warnings are repetitious and a joke. It warns me to be careful prescribing sumatriptan for people with the diagnosis “migraine” and metformin for people with the diagnosis “diabetes”. It throws up the same strings of warnings twice for each drug I enter. You can bet that I consider those warnings carefully as I irritably bash the “acknowledge” key repeatedly.
    I was a software engineer for 10 years before I went to medical school. I’m not a luddite and I can quite clearly see the useful potential for software to support physicians, but the EMRs and near EMRs that I’ve worked with do little to help and much to hinder.