Obamacare: Computerized Medical Records

CNN reports on President-elect Obama’s plan to digitize America’s health care records within 5 years:

[M]any hurdles stand in the way. Only about 8% of the nation’s 5,000 hospitals and 17% of its 800,000 physicians currently use the kind of common computerized record-keeping systems that Obama envisions for the whole nation. And some experts say that serious concerns about patient privacy must be addressed first. Finally, the country suffers a dearth of skilled workers necessary to build and implement the necessary technology.

“The hard part of this is that we can’t just drop a computer on every doctor’s desk,” said Dr. David Brailer, former National Coordinator for Health Information Technology, who served as President Bush’s health information czar from 2004 to 2006. “Getting electronic records up and running is a very technical task.”

It also won’t come cheap. Independent studies from Harvard, RAND and the Commonwealth Fund have shown that such a plan could cost at least $75 billion to $100 billion over the ten years they think the hospitals would need to implement program.

That’s a huge amount of money — since the total cost of the stimulus plan is estimated to cost about $800 billion, the health care initiative would be one of the priciest parts to the plan.

I’ve noticed that enthusiasm for EMR systems seems to be greatest in EMR system manufacturers and politicians.  Real live doctors who actually deliver health care are a lot less sanguine about the whole thing. 

EMR systems have a lot to offer in terms of safety and cost effectiveness for practices and hospitals that are ready for them.  That means the early adopters.  Of course, even the early adopters are a heterogeneous group.  I once rotated through a practice as a resident where the doctors dictated their encounter notes into microcassette recorders so their transcriptionist could type them into the EMR.  The EMR should have partially justified its cost by the elimination for the need of a transcriptionist.

We’ll know truly practical EMR systems have arrived when relatively little training on the part of health care providers is needed to work it.  It’s like that with any mature technology.  Maybe one day every exam room will have a Microsoft Surface-type desktop where you touch and drag a virtual chart around and just set your handheld voice recognition dictaphone on the thing and it instantly downloads and transcribes everything.

One day.  Hopefully.

But Mr. Obama’s plan sounds like a very expensive excursion into the Beta Culture.

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One Response to “Obamacare: Computerized Medical Records”

  1. nice article… thanks

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