Challenges to Using Universal EMR

There are some compelling economic reasons for providers to consider switching to electronic medical records (EMR). The American Recovery and Reinvestment Act of 2009 (known informally in the health care industry as Obama's EMR Incentive) offers physicians a fee of up to $40,000 to do so. However, these incentives alone will not provide the impetus for universal EMR. Many obstacles stand in the way of such implementation, and must be addressed before reluctant practices make the switch.

Reluctance to Change

• Reluctance to chance constitutes one of the greatest obstacles for universal EMR. Many established practices have developed systems over the course of decades, and these systems work for them. Many doctors, especially the older ones, have committed themselves to health care from the time before computers were a common medical tool. While their reluctance might appear technophobic to some, it may stem from resentment to the idea that their practices are considered outdated.

Regulatory Challenges

• From the Health Insurance Portability and Accountability Act (HIPAA) to the Certification Commission for Health Information Technology (CCHIT), various proposed standards still do not agree on what an acceptable EMR package is, much less on how the records should be recorded, shared and protected from abuse. The lack of standards provides no guarantee to the doctor about what he is getting, hindering his ability to diagnose and treat his patients. It would be like purchasing a car in an industry with uncertain rules for safety or construction.

Failure to See Value

• Despite the potential improvements that an EMR can bring to a practice, there are literally dozens of failures for each success story. According to Jack Callahan, vice president of corporate development at MediNotes Corporation, from 40 to 80 percent of all EMR installations ultimately fail. A great number of physicians have reported in articles and blogs that current EMR systems simply do not provide the features, ease of use, and end benefits to compel them to risk the investment into what they consider unproven technologies.

Difficulty of Transition

• Most established practices have substantial paper records that will require a significant investment of man hours to enter into a digital system, and even then, these records are merely stored digitally, with no useful meta-tags or tools to integrate them into the system. Additionally, most clinics have a host of systems they work with that need to be converged, such as billing and scheduling systems. This process would be difficult enough without the added need to do it while processing patients.