Stanley Feld M.D.,FACP,MACE
The follow comment is from a good friend and steady reader of Repairing The Healthcare System. It does not matter what policy wonks think. This is a sincere reaction from an excellent physician.
I have thought a lot about EMR from my days in academia to my days in private practice. Based on my hands on experience with computerizing labs I realized that computers work best for essentially mindless, repetitive tasks or tasks that are the same each time, like accumulating, holding, reporting and filing data. It can also deal with machine control, bar code tasks, etc. Any higher order functions (like thinking) is still not workable. That is what makes computerization of cognitive processes so difficult and is probably at the root of why EMR is not practiced more widely. Add to that the punitive action by insurance and gov't. use or potential use of the data makes EMR a non starter.
If basic patient data (demographics), clinical findings (take your shirt off ma'm or sir), history and treatment could be hooked up with a large data base to guide the physician to make her/him more effective, efficient and better paid, than it will fly."
Your grouchy buddy,
On Aug 4, 2008
There is no doubt that perception equal reality. It is a barrier that must be overcome. I believe it can be overcome with a universal EMR paid for by the click that will be able to be used by physicians and patients for educational purposes and not for data collection to be used against patients and physicians through the use of inaccurate data making judgments about quality care delivered. Quality care has not been defined accurately at this point in time. Quality care is related to clinical outcomes and monetary outcomes not whether a particular test was done on time. It depends on the participation of both patients and physicians. It does not depend on insurance company and government judgements.