As an EMR trainer, I know before I walk into a classroom that I will be greeted by three types of people: those who wanted an EMR a long time ago, those who think the EMR is a good idea but are intimidated by the technology, and those who want nothing to do with the EMR at all. Surprisingly, it is not the first category of people but the second who tend to be the most satisfied with the EMR when all is said and done.
In my experience, many clinicians who are excited about all the benefits that EMRs could offer quickly become disappointed to see a more limited immediate offering. For example, clinicians expecting more accurate billing, faster receipt of lab results, and fewer medication errors may be surprised to learn that their billing, lab, and eprescribing interfaces will not all be going live in the first round of implementation. Oftentimes, EMR implementation is an iterative process in which functionality is built upon as time goes on. The third category of people, those who want nothing to do with an EMR at all, tend to focus only on the EMR’s imperfections and overlook the more universal benefits that it can bring.
A few weeks ago, I was visiting a health clinic about to go live with its EMR. We were doing a final check of their hardware and asking if anyone had any questions or concerns that we could help resolve before go live. One particularly skeptical provider presented me with an
article she had read in the
Washington Post that weekend. The article was entitled “Electronic Medical Records not seen as a Cure All.” I read the article and noted that there were several great points on areas where EMRs could be improved. However, I noticed one thing that the skeptical provider did not mention. Despite all the problems that some clinicians had, one was quoted as saying, “We wouldn’t want to go back.”
I think Dr. David Blumenthal, President Obama’s National Coordinator for Health Information Technology, may have gotten it right when he said, “The critical question is whether, on balance, care is better than before. I think the answer is yes.” Of course any system will present room for improvement, but the important thing is that health IT is moving us in the direction of more effective, accountable, and affordable health care. At a time when everything in health care is being questioned and scrutinized by policymakers, if an EMR trainer can instill the belief that health IT can definitively transform health care in even a small, positive way, that is a powerful thing.