NEJM: Electronic Health Records in Ambulatory Care — A National Survey of Physicians

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NEJM: Electronic Health Records in Ambulatory Care — A National Survey of Physicians

Posted by Ignacio Valdes, MD on Friday June 20, 2008 @ 12:04 PM
from the interesting-developments dept.
New England Journal of Medicine has the results of a study on the very low use of EHR's in primary care with NY Times take on the study. Unfortunately, the message seems to be that financial incentives to doctors for pretty much any proprietary EHR system is what is needed with no analysis or thought whatsoever of their problems vs. open source ones: '...Four percent of physicians reported having an extensive, fully functional electronic-records system, and 13% reported having a basic system. In multivariate analyses, primary care physicians and those practicing in large groups, in hospitals or medical centers, and in the western region of the United States were more likely to use electronic health records. Physicians reported positive effects of these systems on several dimensions of quality of care and high levels of satisfaction. Financial barriers were viewed as having the greatest effect on decisions about the adoption of electronic health records...' Links courtesy of John Leo Zimmer on hardhats. Digg this article

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Re: NEJM: Electronic Health Records in Ambulatory
by S Silverstein on Friday June 20, 2008 @ 12:51 PM

Here is my take on this story: "Price Keeps Doctors From EMR's" - and Price Keeps Me From My Shiny New F22A Raptor..."Of course, other possible factors for the lack of EMR diffusion are simply Red Herrings and myths. Factors such as immaturity of the technology, bad design, unexpected adverse consequences, false assumptions, underestimations of difficulty, lack of understanding of sociotechnical issues that impair acceptance, unclear benefit and irrational exuberance over HIT, demands that clinicians use tools designed by business IT personnel who know nothing of medicine's "hiding in plain sight" complexities, designed and implemented via processes and methodologies best known for failure, produced by an industry rife with conflicts and deception, whose leaders often lack substantive credentials, produce ill-conceived and/or shoddy products whose use is mandated by non-clinician hospital managers and that several other Harvard physicians note in the NEJM here can impair medical practice and education..."

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Re: NEJM: Electronic Health Records in Ambulatory
by Ignacio Valdes, MD, MS on Friday June 20, 2008 @ 10:14 PM

It will be interesting to see if this NEJM article becomes the excuse for one of the bigger boondoggles and taxpayer soakings in recent memory. -- IV

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Re: NEJM: Electronic Health Records in Ambulatory
by Tim Cook on Sunday June 22, 2008 @ 03:58 PM

No matter how wonderful the application is. The lack of interoperability on a sematic level is a true barrier to adoption.

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