EMR-no magic bullet

By Greg Freiherr, Editor, gfreiherr@cmp.com

Medicine wastes billions of dollars. Medical errors injure and kill patients. The answer is the electronic medical record. Or at least that's the feeling I got at the Healthcare Information and Management Systems Society meeting in Orlando, FL, last month.

The tone was set during the keynote address by Newt Gingrich, who championed the idea of electronic data transfer as a means to cure the ills of medicine. Gingrich, once speaker of the House of Representative and more recently the founder of the Center for Health Transformation, pushed all the right buttons for that crowd of data-hungry CIOs. The big red one was the lag by providers in adopting electronic systems.

"Kids get it!" he said.

He told the story of his granddaughter, who carries a plastic purse with a toy cell phone, fake debit card, and an electronic door opener.

Gingrich assured his listeners that an EMR would make the medical profession more efficient and would reduce cost. Who doesn't use an ATM card?, he asked. He then explained how electronic funds transfer takes the cost out of banking. But they do-and they don't.

Savings from ATMs are selective. The money banks save goes somewhere, but not to the consumer. Similarly, there is no guarantee that the EMR will have any effect on the spiraling cost of medicine.

Nor is there any guarantee that the EMR will wipe out or even substantially reduce medical errors. I am reminded of an old saying that the problem with foolproof systems is they don't take into account the ingenuity of fools. In the end, it is people who make the mistakes that lead to medical errors. And it's hard to get around that.

Hospital execs are putting way too much credence in what the EMR can do. When asked to rate projected IT priorities, 47% of respondents to a leadership survey from HIMSS cited reducing medical errors and promoting patient safety. When asked to cite the top business issues in the next two years, 64% said reducing medical errors; 54% said cost pressures.

Sometimes to get things done, there needs to be an airtight case for doing them or people won't act. The problem comes when the goal is accomplished and the airtight case starts leaking.

Moving toward a comprehensive EMR makes a lot of sense. The EMR will help make medicine safer and more effective. But it is no magic bullet. Raising unrealistic expectations about what it will achieve is a prescription for failure.