EMRs Real Politics.

Stanley Feld M.D.,FACP,MACE

 

Dr. Jerome Groopman and Dr.Pamela Hartzmen uncovered the real politics of EMRs.  They are both on the staff of Beth Israel Deaconess Medical Center in Boston and on the faculty of Harvard Medical School.

 Dr. Groopman wrote a best seller “How Doctors Think.”

In a Wall Street Journal article they wrote,

 “The electronic medical record (EMR) is touted as the key to containing costs, reducing errors, improving quality, and simplifying administration: an “elegant exercise in wishful thinking

Dr. Groopman and Pamela Hartzman debunk the 2005 RAND study. The RAND EMR study of 2005 led to President Obama’s belief that EMRs will save $81 billion dollars a year for the healthcare system.

Groopman and Hartzman show that there is little evidence to support the president’s belief.

The RAND analysts claim that more than $350 billion would be saved on inpatient care and nearly $150 billion on outpatient care over a 15-year period of time.

Unfortunately, data from three other studies, a cardiology group, a Harvard group and Canadian group showed there is no savings difference between paper records and electronic records.

Dr. Groopman claims the RAND study is self-serving to EMR software companies that sponsored the study.

 

 Allscripts Healthcare Solutions, the Cerner Corporation and Epic Systems of Verona, Wis. are the major EMR software companies.

 “In February 2009, after years of behind-the-scenes lobbying by Allscripts and others, legislation to promote the use of electronic records was signed into law as part of President Obama’s economic stimulus bill.

“But today, as doctors and hospitals struggle to make new records systems work, the clear winners are big companies like Allscripts that lobbied for that legislation and pushed aside smaller competitors.”

At Allscripts Healthcare solutions, annual sales have more than doubled from $548 million in 2009 to an estimated $1.44 billion last year.

At the Cerner Corporation of Kansas City, Mo., sales rose 60 percent during that period.  

“Current and former industry executives say that big digital records companies like Cerner, Allscripts and Epic Systems of Verona, Wis., have reaped enormous rewards because of the legislation they pushed for.”

Unfortunately, many of the EMR systems bought by large hospital systems and physician practices are not fully functional. They do not fit the administration’s criteria of meaningful-use EMRs. These EMRs are requiring additional hospital systems and physicians; practices outlays of cash to make them fully functional.

Panama City-based Pain Clinic of Northwest FL filed a purported class action lawsuit on Dec. 20, 2012 against Chicago-based Allscripts (NASDAQ: MDRX).

“The purported class action lawsuit says that about 5,000 small group physicians were sold an EMR called MyWay from 2009 until late last year, when the company stopped supporting the product.”

“The company was also hit with a federal shareholder class action securities fraud lawsuit in the Northern Illinois District last year over allegations that it misled investors about the performance of its EHR programs.”

 The MyWay EMR cost about $40,000 per physician. ThePain Clinic of Northwest Florida claims it was misled by Allscripts Healthcare Solution.  The Clinic stated that MyWay has “shortcoming and inherent defects,”  

The complaint says Allscripts was unable to obtain “meaningful use” bonus status for MyWay because of the problems with the program. The lawsuit claims that

 “Allscripts has been unjustly enriched by retaining the money paid by MyWay purchasers and users without delivering an EHR software product that performs as it was intended to work,”

 These costs are always passed on to the consumer. Drs. Groopman and Hartzman  go on to say,

“The president and his health-care team have yet to address these difficult and pressing issues.

 Our culture adores technology, so it is not surprising that the electronic medical record has been touted as the first important step in curing the ills of our health-care system.

But this notion is an overly simplistic and unsubstantiated part of the solution.

It is important to note Drs. Groopman and Hartzman’s total and refreshing frankness.

“We both voted for President Obama, in part because of his pragmatic approach to problems, belief in empirical data, and openness to changing his mind when those data contradict his initial approach to a problem”.

“ We need the president to apply scientific rigor to fix our health-care system rather than rely on elegant exercises in wishful thinking.”

Please note that Drs. Groopman and Hartzman said it not me.

In a new study The RAND Corp has backed off on its 2005 study earlier this year and withdrew its estimate of saving to the healthcare system of $81 billion dollars annually.

In the RAND Corp’s view, the disappointing performance of health IT to date can be largely attributed to several factors:

 

1.  “Sluggish adoption of health IT systems
2.   Coupled with the choice of systems that are neither interoperable nor easy to use;
3.   The failure of health care providers and institutions to reengineer care processes to reap the full benefits of health IT.
4.  We believe that the original promise of health IT can be met if the systems are redesigned to address these flaws by creating more-standardized systems that are easier to use,
5.  EMR are truly interoperable,
6.  Afford patients more access to and control over their health data.
7.  Providers must do their part by reengineering care processes to take full advantage of efficiencies offered by health IT, in the context of redesigned payment models that favor value over volume.”

 

It should not be a blame game.

General Electric sponsored this new RAND study.  It is important to note that GE is a major Allscripts competitor.

There is true value in the EMRs to patient care. However the focus of the marketing and development is on the wrong customer.

The RAND still does not get it. Perhaps it does not want to get it.

EMRs should be for the benefit of physicians and their patients. It must be at a price physicians can afford to pay. It should not be for the benefit of the government, the healthcare insurance industry and hospital systems.

It should be a tool to continually educate physicians and patients. It should not be a tool used by secondary stakeholders to penalize physicians and patients.

Patients and physicians control My Ideal Electronic Medical Record. It should be seriously considered to achieve the maximum benefit of EMRs’ potential.

I believe it would be of value to interested readers to go to this link.

 http://www.lijit.com/search?uri=http%3A%2F%2Fwww.lijit.com%2Fusers%2Fstanleyfeld&start_time=&p=g&blog_uri=http%3A%2F%2Fstanleyfeldmdmace.typepad.com%2F&blog_platform=&view_id=&link_id=7386&flavor=&q=Idel+Electronic+Medical+Record+%28EMR%29&x=33&y=6.

 Those articles will not only describe the problems with EMRs, problems which I have predicted and are now recognized. These articles will also outline real  solutions to having universal adoption of EMRs.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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