EMRs are expensive. They are not compatible with one another. The total cost is more than the government is offering through the stimulus. And if doctors don't respond they're going to have their reimbursements cut.
It all comes down to one complaint. What's in it for me?
It's true. EMRs are mainly about input. They're about obtaining data and storing it. The savings go to patients and (in time) the medical system, rather than the doctors who are paying for it.
But we are now starting to see some health IT that gives doctors what they want -- improved productivity, improved quality, and fewer risks.
Here are two examples.
SureScripts, which built its network to move prescription data to pharmacists, is now adding support for e-mail and EMR files.
Cris Ross, general manager for clinical interoperability at SureScripts, compares the launch of networks like this to the World Wide Web of 1994. "When the Internet came to be used by lots of people for lots of things, all sorts of business models and capabilities emerged," he said.
Add two government-managed open source projects to the mix -- NHIN-CONNECT for networks and NHIN-DIRECT for files -- both of which SureScripts plans to support -- and Ross can finally see a true Health Internet coming to market, with Surescripts in on the ground floor.
Better networks can improve productivity, but what doctors need first are relevant answers so they can make fewer errors. As many as 15% of today's diagnoses are wrong, sometimes because of a shortage of information, sometimes because the latest answer is not on the tip of a doctor's tongue.
One answer being announced today is Autonomy Diagnosis, part of a complete EMR suite from Autonomy Corp. LLC, a British company with U.S. offices in San Francisco.
It started with checklist automation technology obtained with Isabel Healthcare and Joseph Britto, now the parent company's head of medical technologies. "We're able to search for patterns within EMRs, medical textbooks and journals," he says.
So even if a medical office is just starting to build an EMR database, Autonomy can help it make better decisions. As the EMR database grows, the decisions improve, becoming more personal. "You can fix misdiagnoses, and you're creating standards across the institution."
This is what automation is doing in every other industry, Britto adds. "Finance has adopted decision support – why are we in medicine the last to adopt data-driven decision making?"
Maybe because doctors didn't have proper networks or decision support tools. They are finally coming.