Limitations of Electronic Medical Records Identified in Rand Corporation Study

In our December 17, 2012 entry we discussed, among other things, the numerous problems posed by the use of electronic medical records, which all health care providers will soon be required to use. A report issued recently by the Rand Corporation confirms much of what we discussed.

In 2005 the Rand Corporation issued a report painting a rosy picture for the future of electronic medical records. That report was funded by a group of companies that profited from developing and selling electronic medical records systems to the health care industry. A new report just issued by Rand, and not financed by any industry sources, put a damper on those expectations.

The New York Times, in an investigative report published on January 10, 2013, identified the 2005 Rand report as helping to drive “explosive growth in the electronic records industry and encouraged the federal government to give billions of dollars in financial incentives to hospitals and doctors to put the system in place.”

Industry wide savings were supposed to be realized. However, the new Rand report debunks that myth. According to the report, there appears to be little, if any, savings to the health care industry as result of the conversion to electronic records.

According to The Times, the new analysis highlights many of the issues raised by our earlier post; that the systems are hard to use and that they do not permit doctors and patients to share medical information. Indeed, the rush to adopt electronic record keeping has caused nightmares for many health care providers. In some instances the systems were installed and paid for, but never became operational. In other cases medical practices purchased expensive systems, paying as much as $40,000 per doctor, and then discovered that after a few years the system’s seller decided not to support it any longer.

What are the implications for the typical patient? Right now, electronic medical records provide us with limited benefits. Perhaps the best thing electronic medical records provide is the elimination of having to interpret handwriting. This is particularly important in the area of drug prescriptions. Patients can be seriously injured if they get the wrong medication; or the right medication with the wrong dosage. Unfortunately this happens all too often in hospitals. It is anticipated that these types of errors will decrease when all orders are printed, and not handwritten. Other advantages remain to be seen.

What is the future for electronic medical records? First and foremost, uniform standards must be established for these systems. It does not matter how sophisticated a system is if it can’t “speak” to other systems. In fact, it defeats one of the primary purposes for having electronic medical records: making them portable so that a physician can get a patient’s records from a number of different providers quickly in order to treat the patient appropriately. Next, the system has to be user friendly. Ask anyone who uses one of these electronic systems and s/he will likely tell you that they are a pain to use. Finally, the system needs to be cost effective over the long run. But unless the first two issues are successfully addressed, it is our opinion that cost effectiveness will never be realized.