In TEDMED webcast, several vendor executives suggest Meaningful Use and the focus on billing might be making medicine less efficient.
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The criticism of the current crop of electronic medical record (EMR) systems continues, and even some vendor executives are acknowledging the shortcomings.
"I think we've sort of made the paper chart electronic, but what we've done almost nothing of is automation," Dr. Donald Rucker, VP and chief medical officer of Siemens Healthcare USA, said last week during a live webcast from the organizers of TEDMED.
Rucker even suggested that the federal Meaningful Use incentive program might be making the practice of medicine more labor intensive. "Most of the rest of the world uses computers to automate things, to get people out of it, and we've used EMRs to almost get people even more 'stickily' involved in things. We really need to radically rethink, and I think that's a challenge in a Meaningful Use world," he said.
"The state of the EMR systems right now is basically to help hospitals capture their billing information more accurately, and that makes a lot of financial sense to them," added Stacey Chang, associate partner and director of the health and wellness practice at design and innovation consulting firm IDEO. This echoed comments longtime health IT advocate C. Peter Waegemann made to InformationWeek Healthcare last month.
"Whether it's the EMR industry itself or someone who figures out how to deliver value on top of that, at some point those EMRs will only become databases of information if they don't help the physicians practice more efficiently. They are critical," Chang said.
Chang said design and usability might be limiting factors more than technology itself, much like a new study from RAND Corp. said, particularly on the provider side. "If an MD is not engaging in technology, it's probably because it was designed poorly," Chang said. "We've got a whole generation of people who grew up on technology asking for it in the clinical space now."
Rucker agreed. "They're not going to embrace any technology that makes them less efficient," he said.
Though pushback remains, EMR adoption has advanced since the Meaningful Use program began in 2011. This growth has created an "explosion" of patient data, according to Dr. Lisa Bielamowicz, senior VP for physician strategy at the Advisory Board Co., a Washington-based research and consulting firm.
"How do we synthesize all of this information together and who's going to own it, who is going to do that analysis and who is going to feed it back into the hands of a provider so that it is in a usable, actionable format?" Bielamowicz asked. Knowledge has to be managed in ways that encourage physicians to use it, she said, adding that those on the front lines of patient care will not have the time to sort through all this data, so there is a great market opportunity for entrepreneurs and other innovators.
Unfortunately, technological innovation does not always drive down costs in healthcare like it does in other industries. "Healthcare is unique in that every added feature increases the cost," said Dr. Diego Miralles, head of Janssen Healthcare Innovation, part of the Janssen Pharmaceutical Cos. of Johnson & Johnson. The lone exception to date has been generic drugs, which have been shown to reduce spending, Miralles said, although health IT has the potential to do the same.
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