In March 2010 I watched an interview on CNBC called “Medical Records Going Digital” wherein a president / CEO of an electronic health / medical records (EHR/EMR) company discussed various cost savings achieved through his company’s technology. Mainly, the president / CEO was given the opportunity to tout that his EHR/EMR program will allow doctors to see and treat more patients more efficiently. The interview ended with the host(s) saying that this technology would also be helpful in sharing your medical records if you changed doctors; or if you have an emergency where you must see another physician while on vacation in the U.S. or overseas.
Disappointed in the interview, I wrote CNBC expressing my respectful yet substantial concerns with the uninformed emphasis on sharing medical records and the promotion of cost saving through EHR/EMR. In my email I stated that “…it is apparent that supporters of the cost savings argument have not considered the maintenance, administrative, and security costs associated with making health records electronic.” This same sentiment was expressed almost three (3) years later in a January 2013 letter from the American Medical Association (AMA) in which Farzad Mostashari, MD, ScM states that there is still a need to overcome various technological, financial, operational, and regulatory challenges with the use of EHR/EMR. In his letter Dr. Mostashari identified two of the top five concerns with the use of EHR/EMR as:
- Usability of certified EHR/EMR systems and applications – physicians are raising concerns about EHR/EMR usability.
- Health IT infrastructure barriers – presently there is no infrastructure to support the SECURE exchange of electronic patient data between healthcare providers (e.g. physicians, hospitals, clinics, including international healthcare providers).
The concerns regarding technological, financial, operational, and regulatory challenges can also be seen as a precursor to many of the IT service implementation and security problems that are presently hampering healthcare insurance enrollment through the Obamacare website. While there is no doubt that EHR/EMR is a good thing, the underlying service design and implementation with respect to service management and data security is severely lacking. In 2013, fellow Coopers, Richard Pilgrim, wrote a great article titled “Getting it Right: Invest in Service Design”