ATLANTA—Will electronic health records (EHRs) ever live up to their potential?
The question hung over a session, “Transforming Rheumatologic Care with the Electronic Health Record,” here at the 2010 ACR/ARHP Annual Scientific Meeting, as experts lauded the ability of EHRs to improve office efficiency and health outcomes even as they acknowledged physicians’ frustrations in choosing and using new systems. [Editor’s Note: This session was recorded and is available via ACR SessionSelect at www.rheumatology.org.]
“[Health information technology] is an interesting environment in the ACR,” acknowledged Charles King II, MD, chair of the ACR’s health information technology (HIT) subcommittee. “People ask the questions and no one likes the answers.”
The presenters contended that the EHR (also known as electronic medical record or EMR) could indeed be transformative. Robert Warren, MD, PhD, MPH, chief of the rheumatology service and medical director of information services at Texas Children’s Hospital in Houston, reminded the audience that when the stethoscope was introduced, many physicians doubted its value. “So often we think of the electronic medical record as a pain in the rear end, and as purely a documentation tool,” Dr. Warren said. “That is not the way you should be thinking of an electronic health record. It is as much a medical instrument as a stethoscope, I’d argue even more.”
The 2009 federal stimulus package contained considerable carrots and sticks to incentivize health providers to adopt an EHR, noted Stacey Empson, JD, MHA, founder of Epiphany Healthcare Advisors, a consultancy. But the legislation’s intent was to improve health outcomes, access to information, the quality of care, transparency, and efficiency, and Empson believes EHRs can deliver on that intent. “If you adopt an EMR, you will practice, over time, more efficiently,” she said.
As evidence, Empson referred to a recent survey of nearly 1,400 members of the Medical Group Management Association from primary care and specialty practices. Independent practices that used an EHR reported nearly $50,000 more operating margin, while hospital-owned multispecialty practices reported $42,000 higher margins. Costs were highest in the first year, but after five years, independent practices reported 10% higher operating margins than the first year.
EHRs have the potential to greatly improve the efficiency of practice workflows, said Salahuddin Kazi, MD, chief of health informatics for Taos Medical Center. The greatest rewards will accrue to practices that use EHRs as catalysts for change, rather than merely attempting to mimic paper-based processes. “You will get out of the EHR what you are willing to put in,” Dr. Kazi said.
So often we think of the electronic medical record as a pain in the rear end, and as purely a documentation tool. That is not the way you should be thinking of an electronic health record. It is as much a medical instrument as a stethoscope, I’d argue even more.
—Robert Warren, MD, PhD, MPH