What and Why of EMRs, a tutorial: Part 1 – Tips4EyeDocs

In the brief history of electronic medical records (EMRs), the major objective has been two fold. The traditional paper medical records had become unwieldy, difficult to transfer to another provider or to share with another provider. Legibility became a major issue and digital medical data further complicated information sharing.

Patients and the federal government wanted a better approach. This approach must match a patients who had multiple providers under simultaneous or serial care. It must be current, deliverable and portable to follow a patient. And it had to be legible.

Electronic record keeping had begun begrudgingly as large hospitals ramped up billing systems as the practice of health care became  driven by third party payers who wanted an easier way to handle and track claims submissions.  Thus practice management and front office software had a lead of many years of use before the onset of electronic record keeping of medical charts, now called electronic medical/health records (“EMR”).

With the decreasing cost of compute power, the increasing simplicity of programming code and the wide spread expectation that EMR would become a standard way of recording a medical visit, the EMR was born.  But its birth or path to maturity has been more rocky than that of its brethren, the practice management program.

First, the direct tie to improved productivity and revenue were not apparent. Newer metrics for return on investment (ROI) were needed.  Reduced medical errors, the collection of data for medical research and informatio portability became a better know metric than better revenue.

Second, while a hospital had particular control of provider use of EMR within its walls, such control did not extend outside its walls. Office-based providers were under no such pressure to conform to a particular way of recording medical data nor were they pressured to convert to EMR.

Lastly, hospitals and monolithic health centers had a far wider range and depth of revenue sources to finance the acquisition of softeware programs. Such is not the case with an office-based provider who must bear the complete cost by themselves.

EMR software needed an additional impetus to speed its adoption. From successive presidential administrations of either political party, widespread adoption of EMRs for everyday medical practice had become increasingly important with the hopes that medical care costs could eventually be monitored and better managed.  The road has not and will not be easy but is one that our medical care system must eventually adopt if it is to wring out as much excess cost and plumb as much efficiency as it can.

About Richard Hom OD, MPA

Dr. Hom holds Doctor of Optometry and Masters in Public Administration degrees and practices family eye care and consults on public policy, health information technology and program evaluation.
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