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Although “Strong Medicine” (May) does provide some insight into why insurers want electronic medical records (EMRs), it has a lot of misconceptions and misstatements. Among them:

1. “Just as technology streamlined industries like retailing and financial services, it should create efficiencies in health care that will slow premium growth from its traditional annual rate of about 7%.” There are no citations offered to show a decent study demonstrating such “efficiencies.”

2. “Malpractice insurers have already linked electronic systems with better-quality care; some will reduce premiums by as much as 5% for doctors who have gone digital.” Very few have actually decreased their premiums. In fact, EMRs can actually result in increased errors, decreased quality, false documentation, and the loss of privacy.

3. “…only about 9% of the country’s 5,000 hospitals and just under 20% of its 800,000 physicians use computerized recordkeeping….” The only data of importance is what falls into the category of “meaningful use.” The actual numbers are 2% of hospitals and 4% of physicians.

4. “Rand…estimates that when 90% of…providers use such systems, the savings will amount to $77 billion a year.” This has never been proven.

5. “…ROI calculations of such a move showed some modest financial benefit.” Studies have shown that for every group that makes an EMR work, another 50% have a failed installation. And of those that do make their systems functional, only about 10% actually use them “significantly.” Why didn’t the author interview angry doctors who have lost thousands in the quest for the EMR ROI?

6. “For small practices…the price of implementing an EMR system could reach nearly $40,000 per physician.” That’s only the initial cost, which ignores the average $1,500 per month ongoing fees and the cost of “significant use.” Overall, the average five-year cost is estimated to be about $300,000 per physician.

7. “CFOs…may soon develop an affection for EMRs, especially if the technology proves to be an antidote to soaring health-care premiums.” Again, these systems are expensive, rarely show an ROI, and have never been shown to decrease health-care costs.

Alberto Borges, M.D.
Arlington, Virginia

The Author Responds: In most cases, Dr. Borges is referring to projections, estimates, and tangential issues beyond the scope of the article. Previous studies haven’t tested EMRs under the same kind of conditions that will exist should substantial adoption come to pass; that is, with certification, standardization, training — and motivation.

The story did refer to doctors who have had EMRs for many years; they aren’t unhappy, but the systems they use are more like electronic order-entry than EMR. Their views may change, however, if they find out there is no cheap way for them to plug their systems in to the government-sanctioned network. They seem to expect that one of the existing companies (or an up-and-comer) will target them as a desirable market and come up with a solution.

Above article published on

http://www.cfo.com/article.cfm/13687654/1/c_13720245