Policy makers’ expectations for electronic medical records may be too high

The ability for electronic medical records to improve the coordination of patient care may be less than what policy makers are expecting, according to a study by researchers at the Center for Studying Health System Change.

The study on electronic medical records (EMRs) appears in the online version of the Journal of General Internal Medicine.

“There is a real disconnect between policy makers’ expectations that current commercial EMRs can improve care coordination and physicians’ experiences with EMRs,” Ann S. O’Malley, MD, MPH, a senior researcher at the Center for Studying Health System Change (HSC) and co-author of the study, stated in an HSC press release.

The research was based on 60 interviews – including those of 52 physicians and other staff at 26 small- and medium-sized physician practices with commercial ambulatory EMRs in place for at least 2 years; chief medical officers at four EMR venders; and four national thought leaders in the implementation of health information technology.

The researchers found that EMRs are less helpful with exchanging information across physician practices and care settings than they are at making information available at the point of care.

In addition, they reported that clinicians identified many areas where the design of EMRs might be altered and patient care processes could be modified to improve the support of EMRs for tasks involved in the coordination of patient care.

The researchers also found that the current fee-for-service reimbursement encourages EMR use for the documentation of billable events such as, office visits and procedures, but not for care coordination, which is not a billable activity.

Other key findings of the study included the following:

EMRs may have unintended consequences for care coordination, such as information overload;
Clinicians believe that current EMRs may have limited ability to support future coordination needs;
Modifying reimbursement to encourage the coordination of care will likely drive clinicians to demand better functioning EMRs; and
Simply creating incentives to adopt EMRs as they currently exist, given the confines of the current payment system, may result in EMRs being designed primarily for billing purposes rather than for clinical relevance to patients and care coordination.

Reference:
www.hschange.com