In response to the commentary “EMR story stirs strong reactions from AMDIS docs":
Electronic medical records do not improve quality of care. Doctors do!
I hate EMRs, as they slow my workflow. I use several custom-designed databases for specific tasks in my office. I have tried—and tossed out—several Certification Commission for Healthcare Information Technology-certified products. Perhaps the few that can actually be used by primary-care doctors or pediatricians are actually non-CCHIT certified products like AmazingCharts and UniCharts. For specialists with complex workflows, most EMRs are disasters, unless tailored to the practice's workflow. I actually have a state-of-the-art practice with high-quality, real-time information flow between me, any doctor treating my patient and my patient. Every time a patient leaves my office they have their entire chronological digital record secured with 256-bit encryption either in their e-mail or on a USB drive. It is rare for my patients to go to an emergency department or outside hospitals, but when they do, they have the medical information in an understandable, chronological order with them. I can also access my patients' chronological PDF record from any Internet-enabled computer using a highly secure Ubuntu file server. It is a bit more secure than your online bank account access. Voice transcription technology is pervasive in my office. The EMR lobby and some doctors help to perpetuate the "us vs. them" argument, and the EMR lobby often brands "noncompliant" doctors like me as "computer-illiterate old hags." Doctors are actually smart. They know what works best for them and use technology appropriately. If the imposition from outside agencies takes an unreasonable tone or stance (where it is now headed), you will see really good doctors leave Medicare, Medicaid and bad managed-care plans in droves. If EMRs were so useful, we docs would not need any incentives to purchase or use them.
When was the last time the government gave incentives to doctor's offices to use electronic-bill submission? The sole purpose of EMR, particularly CCHIT-certified EMRs is to use doctors as data-entry clerks for the insurance, pharmaceutical and government agencies interested in mining information to suit their needs.
Narayanachar Murali, M.D.
Gastroenterology Associates of Orangeburg (S.C.)Digestive Endoscopy Center To submit a letter to the Modern Physician Reader Blog, click here. Please include your name, title, company and hometown. Modern Physician reserves the right to edit all submissions.
