Monday, November 16, 2009

Electronic Medical Records

An article in Sunday’s New York Times, noted that to date there has been little demonstration of improvement in care or decrease in costs associated with the implementation of electronic medical records. The article does a good job of making a point about why this may be the case.

Simply put, not all hospitals that have implemented the new records have used them to their full extent. Any policy that is going to pour money into additional implementation of electronic medical records will not necessarily solve this problem. It is suggested at the close of the article, that a policy to encourage the implementation of such records should focus on providing incentives to make full use of such records. A key question is how to provide such incentives and whether policies can be used to provide such incentives.

Another reason for a lack of change may be that making any change when care is already “pretty good” is going to require a significant amount of resources. For example, the article points out that “In the heart failure category, for example, the hospitals with advanced electronic records met best-practice standards 87.8 percent of the time; those with basic computer records, 86.7 percent; and those without, 85.9 percent”. In short, while we would certainly like everyone to be at the highest quality standards, if the hospitals using no electronic medical records are already meeting best practice standards 86% of the time, there is not that much room for improvement.

Perhaps without a wholesale, system-wide improvement in the use of electronic medical records throughout the system, any change will be only marginal.


  1. Electronic medical records have great potential for enhancing continuity of care. In directing medical care for my elderly parents (one to end-stage) I have been apalled at how much work it takes to ensure that a patient's relevant medical history gets to where it needs to go (i.e., from one doctor to another). I strongly believe that patients should be able to carry their records with them via a flash drive (or equivalent)- it might be integrated into a medical alert medallion or carried on one's key chain. The key to its value would depend on providers routinely updating the data on the patient's personal record at the time of service. This relatively low-tech approach could have enormous benefits. I wonder, though, if the medical profession trusts patients with their own health data enough to get behind something like this.

  2. I am suprised that we are still having difficulties being on the same page with regards to electronic medical records in this technology savvy world we are living in. I believe that electronic medicals will enhance the delivery of patient care. It is supposed to make cmmunication about patients smoother. Different facilities have different systems for their electronic medical records, which will make accessing patient information difficult. Change like you stated is difficult especaiily if the change shows no significant difference. Edith