Why an EMR doesn’t necessarily deliver better patient care

Regular readers of this blog know that the mere introduction of an electronic medical record doesn’t necessarily guarantee better patient care.

There are multiple reasons for that, including the fact that many systems are archaic in nature, counter-intuitive, and doctors are forced to learn multiple systems.

Yesterday, the WSJ’s Health Blog posted a study showing that hospitals with an EMR don’t necessarily have better quality measures.


According Rand Corp.,

trying to introduce an EMR system to an already complex health-care workplace can cause “a myriad of unintended consequences” in terms of workflow and communication. That’s especially true with the full-bells-and-whistles systems, which include things such as computerized physician order entry system … “The complex systems are more difficult to implement and use,” [the lead researcher] says.

Measures such as pneumonia and heart attack quality scores weren’t improved, and in fact, “quality improvements at hospitals that started using an EMR system for the first time during the study period or upgraded to a more advanced system also mostly lagged those at hospitals that made no change to their EMR capability.”

What does this mean? Hospitals and physicians cannot simply upgrade to an EMR and expect better patient care immediately. It’s a painstaking process that must include physician input at every turn. It’s the doctors that provide the care, and they must be given the appropriate health IT tools to make their lives easier, and not be burdened with the obstruction common to many EMR implementations.

There’s no doubt that, eventually, doctors in the United States need to step into the digital age and document, order, and write prescriptions electronically. But the current generation of health IT isn’t ready for prime time yet, and as such, little immediate quality improvement should be expected of the current electronic medical record push