Why EMR Is a Dirty Word to Many Doctors

Adam Sharp, M.D. | Kevin MD | February 7, 2012

One reason that incentives and threats of decreased payment are necessary for EMR adoption is that the industry and physicians have known for years that EMRs do not improve productivity and that it is highly questionable that EMRs lead to better patient outcomes. So why is all this taxpayer debt being accrued by throwing borrowed money at the healthcare industry to drive EMR adoption, if the end users are so disenchanted? As Jonathan Bush, the Founder-CEO of AthenaHealth (a major EMR supplier) famously said, “It’s healthcare information technology’s version of cash-for-clunkers,” and because it is actually all about control.

The goal of EMRs is to wrestle control of healthcare away from the doctor-patient relationship into the hands of third parties who can then implement their policies by simply removing a button or an option in the EMR. If you can’t select a particular treatment option, for all intents and purposes the option doesn’t exist or the red tape to choose it is so painful that there is little incentive to “fight the system.”...

...For physicians … well, it isn’t hard to figure out where this is all heading. EMRs are quickly becoming the instrument by which we are controlled and managed. As an example, many organizations are already starting to restrict diagnostic testing and therapies via EMR...

Open Health News' Take: 

The author makes a lot of very important points. However he does not seem to be familiar with the open source approach to EMRs. He states "EMRs have been largely a top down effort. Rather than working with physicians to design the technologies and drive adoption, the experience (and almost universally the perception) is that the technology has been thrust upon physicians by administrators." That is correct when it comes to proprietary EMRs/EHRs. If physicians choose open source solutions, however, they have total control of their software. And one of the characteristics of open source EHRs is that they have been built collaboratively by a whole community that includes doctors, nurses and other clinicians. This means that open source EHRs work the way that physicians work. The challeng is that proprietary EHRs have huge marketing budgets and pretty brochures, while open source EHRs are generally discovered through word-of-mouth. At Open Health News we hope to provide the information so physicians can pick open source solutions that fit their needs. RAM