The NY Times ran another piece today on the potential benefits of an EMR platform. I'm not sure who was *behind the story*... but i disagree with a number of the statements and premises of their article.

I have blogged about this topic often enough.... here, here, and here.

I am not against technology. I am against  *shouldering the burden*, and *paying a fortune* for technology that will probably not enable my patients, will not materially affect my business,  and as currently designed will not reform health care or the practice of medicine. EMRs, as currently available today are in their infancy. They are, for the most part, very poorly engineered, very expensive, and do not allow me to share patient data with hospital, RHIOs, etc.

Physicians innovators should have taken the lead on EMRs...but we didn't. We should have been involved at all levels of the platform's build-out, but we weren't.

Who benefits MOST from an EMR, and the sharing of knowledge, tests, and procedural data... *nope*, not the patient... the managed care industry!!! *IF* technology such as an EMR platform decreases the number of duplicated procedures, the industry's profits rise. IF they need to fewer FTEs to handle electronic claims,  their profits rise. Do you think they will decrease their premiums if their costs go down???? Nope. Look at the airline industry. Gas/fuel are at 4 yr lows... yet we are still paying a fuel surcharge!

So, if the MCOs are going to benefit most...WHY SHOULD THE DOCS, many of whom are already operating on a very fine margin, SHOULDER THE ECONOMIC BURDEN of purchasing, rolling out and maintenance of an EMR system that most relevant research shows they probably will not like ????

“This requires the usual leap of faith that knowledge will yield good things — better care, doing things smarter and, yes, saving money in the long run.”

Leap of faith??? I'm not jumping out of a plane and relying on a parachute opening. Design a platform I like, align the interests/economic burden of those who prosper from the IT expenditure, make it economically feasible, make the systems inter-operable, the data actionable and computable and I will be the first one to sign up.

"We have to restructure our medical culture,” he said. “We have to promote a culture that believes in the evidence and is trained in analyzing the evidence. It’s the only long-run answer to the challenges we face in health care — evidence-based medicine.”

This has nothing to do with evidence-based medicine (EBM). Whenever possible I have been practicing EBM for years. The problem is we do not have enough evidence. Without inter-operability, currently available EMR platforms will not lead to a plethora of EBM data.

There has to be a better way...another reason why the Obama administration needs to fund the Health Care VC sector to allow for disruptive innovation in a space clearly in need of a new way of thinking. In addition, this clearly points to the need for physician thought leaders to be actively involved in the innovative process.