Concerning the comments by Bill Bysinger, if there are large-scale placebo-controlled, peer-reviewed studies showing the clear value of electronic medical records to patients and physicians to offset the time and money required to put them in place I would like to hear about them. The studies I have been able to find either show EMRs to actually cause more harm than good or to show very little benefit. Many of the studies that are available do involve small numbers and less than perfect methodology, but they are the only studies publicized to date. I suspect with most of the medical society leadership, the government, the Leapfrog Group and the vendors foaming at the mouth for EMR adoption that any and all positive studies would be made public immediately. That such publicity does not exist might mean that such positive studies also do not exist.
Do not fall into the trap of thinking that just because a given result seems logical it must be true. Any physician can name many logical assumptions (estrogens, anyone?) we were taught in medical school that when properly studied turn out not to be true. I plan to forgo any EMR purchase until there are many excellent studies proving beyond any doubt large benefits to my patients. And the benefit will have to be balanced against the cost in time and money of putting such a system in place. As for ignoring the pop-up advice from the software, there are reasons why this happens. In the rush of caring for the number of patients the average physician is expected to provide care for daily, there is not time to pay attention to the large number of pop-ups that occur, many of which are trivial, not applicable to the specific patient and sometimes just plain incorrect. None of the clinical assistance software I have seen is worth anywhere near the amount of money the vendors are asking for it. Get back to me when this stuff has been perfected and road-tested.
Everest Whited, M.D.Pflugerville, Texas To submit a letter to YOUR VIEWS, click here. Please include your name, title and hometown.