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Tuesday, April 13, 2010

Costs A Lot and Not Worth the Price

My last post was called "It don't cost nothing and it's worth the price." The EMR (electronic medical record) industry is quite another matter, an example of where most things cost a lot and are worth much less. I must exempt Amazing Charts, the $999 little guy, which is an incredible value. I tried it and considering the cost, it was good despite some limitations. But the other EMRs, some of which I've worked with in previous settings, have limitations too, and they cost much, much more.

As pointed out by the owner of Amazing Charts, Dr. Jon Bertman, on his own blog and on the Amazing Charts website, the availability of federal ARRA (American Recovery and Reinvestment Act) stimulus money has corrupted the EMR marketplace such that EMR vendors are trying to get their product to cost exactly as much as the maximum amount that physicians can get from the federal government to support the installation of an EMR. As he pointed out astutely in his blog, some conflicts of interest are at work related to connections between the Obama administration's advisors and EMR vendors. All this frantic activity with hundreds of vendors and investors in the vendors trying to sell over-priced record systems to physicians makes me glad that I don't take Medicare. I'd rather just practice medicine. Medicare and insurers generally don't pay for what I provide, that is, in depth, extensive, thoughtful internal medicine consultations and research about your medical condition.

As readers of this blog already know, I believe in the patient-centered model of medical record keeping, with patients having their own personal health records, (PHRs) to which providers such as doctor's offices and hospitals have portals and upload data about the patient. This achieves true "interoperability" (fancy word for doctors' records talking to each other and to other health care facilities), with the patient as the hub. Therefore, my main concern with an EMR is that it easily upload electronic data to a patient's personal health record. I'm waiting for Peoplechart (the PHR I recommend to many of my patients because of the availability of staff to help with the inputting of and indexing of the data), or Google Health, or Microsoft Vault, to create a physician EMR, that speaks easily to their PHRs as well as to other EMRs. I've been trying to get an EMR vendor to collaborate with a PHR vendor to do this, but so far there hasn't been any incentive for them to do so.

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