So many products, So few solutions?
One important question is why, given that there are any number of vendors already marketing electronic medical record (EMR) products, this area is considered to be so lacking? Is it that physicians aren’t adopting these solutions, or are the solutions that exist not meeting the needs of the market (and, in turn, the American healthcare consumer)?
I believe it’s both. I also believe it’s far too big a problem to cover in one post, much less one blog. Or book.
Adoption rate of electronic health record (EHR) and EMR software is nearly 40%. A number of factors are acknowledged to play into this, both at the practice level (cost, perception of expected productivity gain, physical space) along with legal and business reasons such as ownership of the EHR itself and competition. Certainly there are more, and I make no claims that this is an exhaustive list.
I do find it interesting that several of the reasons in this non-exclusive list are related not to the technology itself, but rather to fear: fear that (without committing fully to the EHR implementation) the productivity gains promised won’t be realized, fear about the legal repercussions of collecting cross-provider data into one record, and fear of making it too easy for a patient to go elsewhere.
Sam’s club is attempting to address the cost concern, and the federal stimulus money should help with this barrier. Technology continues to evolve into smaller, more targeted form factors and purpose built devices – this trend promises to address concerns with space in the clinic, and fitting office technology into a clinical setting.
One overarching challenge is that even if we overcome all of these factors — including the fears of legal and competitive concerns — and doctors all get on board and decide to share their patients’ information in the interest of improving care, there is an underlying challenge with transferring information from practice to practice: semantics. From practice to practice, a condition or a treatment may be coded with similar but unequal terms. Either these unequal terms must be linked to the same code to allow the system to resolve the discrepancy, or the system must learn to interpret the language well enough to identify cases where distinct terms are not equal and when they are. Otherwise, what is delivered from one practice to another must be displayed to the clinician for translation and action, rather than acted upon automatically.
So what’s the solution? Is the problem technological or interpersonal?