The Need For Better Tools.

By Marcy Zwelling, MD

Health information technology is here to stay.  But, is it really a good thing for the medical industry? Does it really improve patient care? The government would have us believe so.

The government has put its foot forward with a huge investment in the electronic health record.  The stimulus package included billions of dollars to induce doctors to purchase an EMR by offering $40-50,000 if the doctor participates in a program that they call meaningful use.  Meaningful use requires that a doctor send data to the doctor and that he participate in E-prescribing.

The electronic health record would be a HUGE opportunity if it collected good clinical data but to date, it still remains mostly a billing opportunity.  The data extracted is financial data and actually gives us bad information. The government will be collecting that information but depending on what they do with it, it could be a step backward rather than forward.  Bad data is worse than no data.

The electronic health record would be a HUGE opportunity if it created a sequential look at our patients’ health relative to the rest of their life.  But, it remains event based and fails to deliver the right clinical data. If we could track our patient’s health using input from their daily activities, we could learn a lot about why things happen.  Health is not an event; it is about a life.  We need to build a better EMR in order to capture useful clinical data.

Finally, the electronic health record along with E-prescribing could be a wonderful opportunity to save time, improve accuracy, and save paper (and money).  But, insurers and pharmacy benefit managers have already undermined vendors by obstructing our ability to put in our drug of choice.  Some programs do not allow doctors to prescribe what the patient needs.  The keyboard actually will not enter the drug into the appropriate space.  The electronic health record and E-prescribing has (in these instances) become obstructive.

It is time the HIT industry hear doctors “better.” They need to address our patients’ needs.  A tool is only good if it helps us perform better. When it is obstructive, decreases productivity, doesn’t answer the questions we are asking, and when it gets in the way of good patient care, we need to go back to the drawing board and get it right.