EMRs, Electronic Billing? The sky is falling, the sky is falling! Extra, Extra Help
Monday, July 12, 2010 at 8:26AM 
R.J. Hammett, DC
INTRODUCTION
The government says EMR’s by 2014, state boards and associations are setting up committees and groups to study the solutions for the coming EMR catastrophe.
EMR software vendors are advertising like crazy, why? Their software is the one to buy, and you better buy it now before its mandatory. Ok, I’ve listened and looked; I’ve even tried a few EMR systems. So what are the facts?
1. There is no standardization of EMR for chiropractic or medicine. In Britain a $20 billion dollar program for EMR’s is 5 years behind schedule and heavily over budgeted.
2. The majority of EMR software cannot communicate with other EMR software.
3. As of June 2008, only 4% of medical physicians really use EMR’s in hospitals or private setting on a regular basis.
4. Error reporting on EMR’s is high with regards to quality studies.
5. A JAMIA research paper of 2006 concluded that “the promise of improved care quality and cost control has prompted a call for universal EMR adaption by 2014.” The EMR products now available are unlikely to achieve full diffusion in a critical market segment within the time frame being targeted by policy makers, it may reach the target by 2024!!
6. According to NYT, Doctors annually reap about 11% savings from EMR’s, the rest goes to insurance companies (again). The doctors bear all the costs, and others reap most of the benefits.
7. The capacity to manipulate electronic records is a risk management nightmare!!
8. Doctors become distracted by the computer program, lessening their ability to focus on their patients (the TV in the room syndrome).
9. Privacy and security issues; according to JAVELIN strategy and research; 275,000 incidences of medical information theft occurred last year, with 260 million medical data breaches since 2005 (so much for HIPPA).
10. The American public has been surveyed several times and overwhelmingly (74%) do not trust the security of electronic records.
DISCUSSION
So, what are you to do? With EMR systems costing $10,000-$20,000 and with the above in mind, what’s the answer?
Unfortunately there is no clear cut route for the private practitioner. While it is sure that clinics like Mayo, Harvard in Cleveland can benefit for large main-framed based EMR’s, does this fit the small time solo Chiropractor?
I hate to say it, but its wait and see time. Yes, get involved with your board and association (Are you listening Minnesota?) before anyone mandates and unproven system for note taking that isn’t ready yet.
Will EMR’s happen? Yes, is now the time… Absolutely not!
Technology and policy has not caught up yet, when it does, then do it! But until they do the things you know, that works every time… ADJUST!
Til next time. RJH
