Lately, a lot of articles and blog posts from providers, regulatory experts, and journalists have said some pretty nasty things about electronic medical record (EMR) systems.
For example, Megan McArdle, correspondent for Newsweek and The Daily Beast, wrote an article that featured statements from readers who have transitioned to EMR or know someone who has. In short, they are not convinced EMR will save time, bend the cost curve, or improve quality of care for patients. In fact, they think the opposite is true.
One reader said his wife, an “overworked family doctor,” was sold on the promise that EMR would be a time-saver. But instead, she spends more time clicking check boxes and selecting drop-down menus and less time with her patients. Another reader, who is also married to a doctor, said his wife’s biggest complaint is she can no longer dictate her notes, lamenting that she has been turned into a “data entry clerk.” Yikes.
EMR proponents also promised the technology would lower healthcare costs, by ensuring more accurate coding. But it appears that promise has not materialized either. When physicians enter services provided into the EMR system, some systems will ask the physician if they also provided additional services that he or she may not have realized were billable. These prompts make it easier for the physicians and nurse practitioners to ensure they are reimbursed for all the services they provide, but it doesn’t bend the cost curve
In fact, the U.S. Departments of Justice and Health and Human Services think EMR technology has made it easy for providers to “game” the system. Some experts worry that facilities have created templates that are designed to facilitate coding encounters at the highest possible level, regardless of whether physicians or nurse practitioners provided the appropriate level of care. Others say providers can easily copy and paste notes from previous patient encounters to make sure documentation is sufficient for more expensive codes.
Regardless of the growing pains providers are going through, EMR is here to stay. Perhaps healthcare providers just need to change their perspective. I think Dr. Rob Lamberts summed up the EMR struggle best on his blog post titled, “Learning a New Language | An Insight into EMR.”
“The reality is that EMR systems are designed to finesse the payment system more than they are for patient care. That is because the thing we call ‘healthcare’ refers to the payment system, not to actual patient care. My frustration with my current EMR system is not that it doesn’t do its job well (it still is better than my old one…I think), it’s that it is grown on a planet where the honor being a healer is being consumed by the curse of being a provider. Patients don’t matter as much as payment in our system, so EMR systems will follow those priorities. Those who don’t will not succeed.”