AMA on EMRs

In 2009, the American Recovery and Reinvestment Act required that by this year, seventy percent of primary care providers should be using Electronic Medical Records (EMRs). Perhaps unsurprisingly then, the AMA has just issued a press release complaining about them.

ama-logoWhile it may be reassuring to discover that your doctor finds forms just as confusing as you do, the problems with EMRs or EHRs (for “health” records) can affect the care you receive.

Ideally, an EMR (sometimes known as an EHR, for “health” records) should be a complete computer file of all your doctor visits, conditions, complaints, and prescriptions. Everything you tell your primary care doctor should be easily readable by the specialist(s) she sends you to see, avoiding time-wasting repetition and the risk of contra-indicated medications.

The reality is that, alas, EMRs are currently provided by many competing vendors, leaving doctors with many different products to learn that don’t inter-operate as promised. When medical providers should be listening to you, they may instead be distracted by trying to figure out what field to fill in on the electronic form. Worse, many of the promises of mobile health—that you should be able to check your own records on your smart phone, for example—are also on hold while the technology evolves.

The AMA lists the following priorities for fixing the problem:

  • Enhance Physicians’ Ability to Provide High-Quality Patient Care
  • Support Team-Based Care
  • Promote Care Coordination
  • Offer Product Modularity and Configurability (make it customizable for particular specialties and institutions)
  • Reduce Cognitive Workload (in other words, make it less confusing!)
  • Promote Data Liquidity (make it easier for information to “flow” back and forth among providers by using common terms and other standards)
  • Facilitate Digital and Mobile Patient Engagement
  • Expedite User Input into Product Design and Post-Implementation Feedback

The importance of finding the right fix is explained by Steven Steinhubl of the AMA Advisory Committee on EHR Physician Usability: “Given the rapid growth of digital technology in health care, whether for health and wellness, or the management of chronic illness, a comprehensive health information technology strategy must include interoperability between a patient’s mobile technology, telehealth technology, and the electronic health record.”