There are some studies out there, and some loud readers of them, which argue that EMRs have never been shown to improve health outcomes. The argument goes that it's a "cost imposition" on practices to adopt these technologies with no clear benefit to patients. My day to day experience screams nonsense. The "benefits" of good communication and coordination of care are hard to measure in a system lacking these attributes, but that doesn't mean benefits aren't available. It just means you can't weigh something until you have some of it.
When my staff and I interact with practices that still document medical visits as if it's 1984, what we experience is a system with very poor communication patterns with patients and between physicians. Yesterday, I called a practice to which I send a large number of patients for consultations because we've had a consistent problem getting reports sent back to us. The excuses given by the office manager boggled my mind, "but doctor - we have PAs who see patients and their written notes need to be dictated and then reviewed by the doctor before being signed and sent to Medical Records and then brought back to the chart and we always make sure that after that we send..." yadda, yadda, yadda.
It's simply not acceptable that we continue to describe our dysfunctional and antiquated healthcare processes rather than stepping back and saying "wait a minute - a six week process for developing and sending a note can be streamlined to a few minutes with very minimal investment." Get an EMR, use it to document visits at the point of care, click on the button that says "send this report to consulting physician" and be done. It's just not that complicated, except that we lack the vision for simplicity.
I generate and send specialist referrals in the exam room during my visit with the patient. It takes about 30 seconds, reinforces to the patient the importance of making the appointment, and saves our office staff from the pointless form creation and faxing that wastes time and money. No other industry still operates as if nothing has changed in 30 years; only healthcare, with it's indefensible disconnect from quality improvement gets away with this nonsense.
By the way, I spent nothing on my EMR that documents visits, sends direct referrals, replaces written prescriptions with secure electronic ones, and allows me to access records anywhere and anytime that I have internet access. It's 2010. Very cheap or even free technology is ready to escort U.S. healthcare into this millenium if we have the vision to stop describing and start changing how we operate.
