Commentary: Your Stake in Electronic Medical Records

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The government recently set an aggressive timetable for doctors and hospitals to adopt electronic medical records. Financial incentives for updating technology will begin in 2011.

The administration's announcement has spurred a flurry of meetings between healthcare providers and IT vendors to get the ball rolling. This is a major step in transforming and automating our beleaguered healthcare system.

But as these backdoor meetings take place, why are you still filling out paper forms and seeing doctors scribble notes on paper charts? And does it really matter?

In short, yes.

It is mind-boggling that the trillion dollar healthcare industry is one of the last holdouts against automation. Not only are paper records slower and more restrictive to open, share and cross-reference, they are expensive to store in large volumes. But the move to EMR is not just about making process more cost-effective.

Patients have a big stake in this, too.

Converting patients from a manila file folder to an electronic record that is easy to interact with can make a difference to health outcomes. For example a recent study by Kaiser Permanente showed that e-mail use between patients with diabetes and hypertension and their doctors resulted in improved quality of care scores – and a 2 to 6.5 percent improvement in factors like cholesterol and blood pressure screening.

Nine out of ten still on paper

Despite these benefits, 80 percent of U.S. physicians’ records and 90 percent of hospitals’ records are still on paper. One reason is cost – the average price tag for setting up EMRs is currently $38,000 per doctor’s office, plus an additional $10,000 a year to maintain the system. Doctors themselves are an obstacle, too. Already feeling pressed for time and buried in paperwork, they find new systems difficult and time-consuming to master.

Security is a major concern, too. Patients’ worries about the privacy and security of their health records today are similar to the concern people had about Internet shopping and banking five or ten years ago. Consumers need to know that today’s EMR systems and related applications are hosted on secure platforms, with data accessible only by credentialed healthcare providers. These systems must also comply with strict HIPAA and data security and privacy regulations. Together these safeguards mean that patients can gain the benefits of collaborative care, which is driven by physician access to connected and integrated healthcare records.

"Despite the current obstacles and natural human reluctance to change current ways of doing things, I believe that in another five years, no-one will even remember the endless paper forms we filled out at doctors’ offices." -IBM, Rob Merkel

Are the walls coming down?

Widespread use of electronic medical records is a matter of when, not if. The Obama administration has set an aggressive timetable for EMR, with incentives for doctors and hospitals starting in 2011. Healthcare providers that don’t adopt EMRs by 2015 will face penalties. Some insurance companies are getting ahead of the curve -- Aetna, for example, is offering new solutions that make better use of the data collected by existing EMR systems.

Software and hardware vendors are making things easier for doctors with cloud computing and secure web-based computing. These applications let doctors use the same laptops they’ve always used, but it gives them access to large volumes of clinical data, patient history and even 3D avatars that help doctors visualize medical records.

Long-term prognosis looks good

Despite the current obstacles and natural human reluctance to change current ways of doing things, I believe that in another five years, no-one will even remember the endless paper forms we filled out at doctors’ offices.

The use of EMR as a standard way to exchange healthcare information will lower the costs of healthcare delivery and let physicians get back to the basics — thoughtful, holistic patient care. And it won’t stop there. Doctors will be able to take a proactive role in patient care, anticipating potential problems and dealing with them before they even arise, because they will have visibility into their patients’ complete medical records across the full range of doctors and healthcare providers.

Converting paper files to electronic medical records won’t solve all the challenges faced by our healthcare system, but it is an important step. Patients, physicians, healthcare providers and payers — we all need to work together to support the adoption of EMR because everyone has something at stake in transforming our healthcare system.


Rob Merkel and his team at IBM work with every one of the top 14 U.S. hospitals; 12 of the top 13 healthcare insurance companies; every one of the top 300 pharmaceutical companies; and 18 of the top 20 biotech companies to address unique IT challenges.