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Dear Scott:
with all due respect, you are not a physician and you have not used an EMR in daily life. I just finished implementing an EMR in my practice - as a hospital employed physician I did not have to buy the system, just start using it.
It slows me down, it drains your productivity, it makes simple tasks complicated and long, it takes clicks and click and clicks and more clicks. It does not give you the same quick overview of a patient that my paper chart gave me.
It is just a drain!
Very simple. No need for complicated arguments. Make the damn systems better and people will use them. Sounds simple, and it is simple.
Design systems so that physicians can adapt them to work exactly the way they want and then make them cheaper. Lower the abusive costs.
And I will be happy to help with suggestions if you want. But you may just continue to write important words in long articles instead of finding a company that produces a really great system.
Your Matthias Muenzer, MD ObGyn
muenzerus@gmail.com

I enjoyed your post and agreed with many of your points, except the following. EMRs have not been adapted widely for the following reasons. They are too expensive and less efficient for the actual, in-the-trenches-providers. Also, contrary to the “doctors are not good business men” argument, doctors will adopt EMRs when they see ROI. For large groups with multiple locations and providers, the ROI is obvious. For a small practice like mine that has one location and a bare-bones staff, an expensive EMR would never have ROI, despite what the vendors’ marketing pamphlets say.
And, I am an EMR supporter and use one in my office, only mine was custom built by me for me. Any case, I liked your post and dialogue is always good to have.
Dr Schoor

[…] Low Adoption of Electronic Medical Records: Hidden Reasons? by Scott MacStravic, World Health Care Blog June 29, 2007 at 2:14 pm · Filed under Electronic Medical Records Adopting and particularly sharing EMRs have been major features of most expert suggestions for health care reform. Despite their availability for two decades, their adoption in the US is well behind most European countries, as well as China, Japan, Australia and Russia, at less than 20% compared to 50-90% and more elsewhere. Whatever the benefits of EMRs, to patients, payors, and the country as a whole, we are only slowly and somewhat reluctantly gaining them. […]

[…] Article. […]

The low lack of EMR adoption absolutely not related to lack of bussiness knowledge among physicians. The EMR products available are pathetic, products designed by people who have no idea how doctors enter data. These products slow down the physicians . It makes poor bussiness sense to buy something which will half your income. The larger practices end buying up programs worth millions of dollars. The buying is done by administrators and senior physicians with ideas similiar to expressed in the above article. These people are taken in by smooth talking sales people and then get stuck with a white elephant. They then force the EMR product down the physicians throat.
There is only one word to describe the notes generated by the major EMRs in the market: “pathetic”. There are relatively few ok EMRs. But there are no good EMRs. So be aware of these smooth talking sales people before you take the plunge.

well, just aswell cheap buy uk stock really cheap electronics products. Make me looking foward to xmas already

Agree with the other docs posting comments. Scott MacStravic is showing his ignorance about the real problem with EMR’s. They are bad at what they do. They are hard to enter data into and get information from. The cost is secondary. Actually they are cost efficient in that you don’t need as many records staff, so they do save money, even for a group of 6 or more, and often for a group of 4 or more. However, they work so badly that physicians will pay the cost of more expensive paper systems because they work better.

If you look at the overall tone of the article it makes the underlying assumption that doctors just are working with only their limited self interest in mind, and that they are pretty clueless to ignore all the benefits of EMR’s. I see this a lot in commentary about EMR’s. Actually, time and time again physicians have demonstrated the lead in improved patient care even against their own financial interest. Better would be to ask the question why is it that with stories about how beneficial EMR’s are, why dont physicians use them. With that question you would hear over and over from physicians how bad they are and how much we would like to use software that is actually helpfull in caring for our patients. If only the EMR vendors would design a good product.

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