Here is my response to an article by Ken Karpay in the periodical, Physicians Practice (July/August): http://www.physicianspractice.com. The article's thrust is fairly obvious from the title: that electronic medical records are on the way, in a big way, whether physicians resist or not, but with potentially great benefits to us, blah, blah, blah...
EHRs are coming – Like it or Not
I recently read your ‘Politics and Your Practice’ column for July/August of Physicians Practice. I too believe we have reached a ‘tipping point’ in the migration toward EMR in medical practice; politics surely has proved to be the critical force in the impending turning point. In general, I agree with the main thrust of your article. As a physician and medical informatician in
I would expound on one point you made in the article: “…you will have something you’ve never had before: hard data about your practice.” Control of one’s data is the critical point here. Many central entities around the nation (Regional Health Information Organizations, or RHIOs, for example) are forming in an effort to entice/push (depending on your perspective) physicians toward EMR adoption. These efforts often entail centralizing data (e.g. lab data) in a community; in some areas of the nation the efforts are quit evolved—e.g. offering an ASP (application service provider) model to deliver EMR technology from a central source. The central stores of data in these initiatives will have the potential to NOT be in the control of individual practitioners. This potentially could serve as yet another means to micro-manage physicians’ practices. And if you think current “report cards” often produced by IPAs today are detailed just wait until the highly granular data from an EMR makes it to a centralized data repository. Third parties will have unprecedented access to very detailed information regarding practice operations.
I implore physicians and other providers to educate themselves about health information technologies. We all must ensure that we have first access to the data we collect; that we retain a high degree of control over these data. The risk is that we become glorified data entry personnel for third parties (to a greater extent than we already are) and hence, actually diminish our already slipping grip on practicing medicine. I am a big advocate of information technology. However, if physicians approach EMR adoption passively (or passively aggressively) they risk getting run over by this horse that is clearly out of the barn.
Egan F. Allen, MD
Internist and Health Information Technology consultant