The Electronic Medical Record (EMR): Still Waiting

January 1, 2008 -- Rates of adoption of EMRs in the United States continue to be abysmal. Here are some recent numbers (per the California Healthcare Foundation's Snapshot: The State of Health Information Technology in California, 2008):

  • Just 12% of California physicians use alerts to warn them about potential adverse drug events, receive electronic warnings about abnormal lab results, and send reminder notices to patients about regular or preventive follow-up care.

  • Only 25% of hospitals are using bar-coding technology fully for tracking lab specimens and only 13% have implemented EMRs.

  • Many patients do not communicate with their physicians online because they are concerned that on the Internet their privacy might be compromised.

Nearly three-quarters of medical groups in California continue to rely on paper records. Healthcare information Technology (HIT) offers substantial, well-documented benefits both to reduce costs and to increase quality. Why aren't we using it?

The EMR has always been a focal point of my career. When I graduated from UCSF in 1983 with an MS degree in this area (having built a rudimentary EMR for my master's thesis) there were no jobs where I could put these skills to work. But that has changed. Today medical informatics is an industry. For example, both of my recent hospital employers -- Sutter Health and Kaiser Permanente -- have huge EMR implementation projects underway. Several doctors I know are investigating EMRs for their offices. However, industry-wide standards remain largely absent and paper charts remain the norm.

We're still waiting for the revolution.

Table of Contents