Jan 8th, 2009 by Ben Obama: 100% EMR in 5 Years
A few weeks ago, I blogged about how Obama wants to include EMR investment as part of his economic stimulus package. Today, in another speech on stimulating the economy, the president-elect made the below statement:
To improve the quality of our health care while lowering its cost, we will make the immediate investments necessary to ensure that within five years, all of America’s medical records are computerized. This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests. But it just won’t save billions of dollars and thousands of jobs – it will save lives by reducing the deadly but preventable medical errors that pervade our health care system.
The 2014 date for 100% EMR usage isn’t new; President Bush set this goal in 2004. What’s new is Obama’s continued, high profile mentions of including EMRs as a direct part of his economic stimulus plan.
While many feel that the 2014 date is ambitious, we’re excited about the huge push this could give to EMR adoption. I just hope that the funding is distributed in a sensible, non-bureacratic way so it provides real benefits.
January 9th, 2009 at 8:34 am
[...] Some folks feel encouraged by this goal, which mirrors President Bush’s goal date of 2014 for having the nation’s medical practices making the paper to EMR transition. Others are more reserved, citing the difficulties in investing in the conversion with so little money to go around — from any source, including patients, these days. [...]
January 9th, 2009 at 9:46 am
Clearly Obama has never tried to use any of the EMRs available. Maybe if Microsoft or Apple made an EMR this goal would be realistic, otherwise I think it’s a complete shot in the dark. The current offerings aren’t going to be able to sustain that type of growth or scalability. Best guess estimates are that under 20% of providers anywhere on EMRs and that includes hospitalists whom are forced to be on EMRs. So in 5 years, we’re miraculously going to get the last 80% of hold outs on EMRs? Good luck!
Also, if you think there aren’t great EMR consultants now, just wait until the government starts pouring money into a project.
January 9th, 2009 at 10:51 pm
I’m getting on the EMR bandwagon. If there are any software companies, Microsoft, Apple, or whomever the newest of You will be let me know your name and the date you submitted your proposal to the Obama administration and I will throw the full weight of my database management expertise into it, with full heart and purpose.
I’m here to help with database management expertise – at a recession proof salary.
Will you join me?
January 26th, 2009 at 4:48 am
This was crazy-talk when Pres. Bush set the date, and it’s still crazy-talk, even if Pres. Obama repeats it. Becky is absolutely correct. In addition, how many times have all of us developers heard that physicians require from 6 months to 2 years to be productive on an EMR system? How many physicians will refuse to implement because of the enormous burden an EMR implementation forces on the entire clinic staff? How many close-to-retirement physicians simply do not have the computer skill set to use an EMR efficiently? You don’t implement EMR like you would a new version of Microsoft Office or iTunes; I’ve yet to hear any government advocate of EMR acknowledge the inherent difficulty of radically changing physician “cultures” and expectations.
February 5th, 2009 at 12:04 am
I love the support from Government, BUT feasibility? Not quite…. There are approximately 563,000 providers in the US, layer in support staff and nursing and the numbers are huge. Given that in ambulatory care we’re still in the 18 – 24% adoption range depending on what journal one reads, 5years is a dream, especially since the outstanding 80% has not selected a system yet (generally a 30-120 process for even solo practices). So let’s take the example of 80% or 450,400 providers needing implemented with a typical 180day implementation per provider (wouldn’t that be nice). Over a 5 year period each implementor (given 1 man teams per provider) would have 1300 days of productivity available (based on a 2080 hour work year). That works out to needing 62,363 implementation people to meet the 5 year goal in an ideal world, all with a skillset that would be drilled down to maybe 10-15 specific EHRs that cater to the entire industry.
Remember the big gap here is actually implementers within the industry. Today, vendor backlogs can be rather large already, just consider a surge of purchases for a concentrated few, based on certification. I agree with Greg, more focus needs to be placed on the culture change and expectations. This is critical for successful implementation and not something that occurs overnight. That said, it is encouraging to see incentives and penalties being established for adoption/non-adoption, we should just hope that Govt. does not place unreasonable start dates around specific incentives/penalties that would create undue pressures on an industry that already has trouble with widespread adoption.
February 9th, 2009 at 9:47 pm
The government does nothing well when it has a lot of time. When they rush things, they create havoc. They are spending the public tax dollar and it is going to be thrown away in buckets. John Weir comment was very true. As a veteran of over 30 years in hospitals and doctors offices, I can go all the way back to HEW reform of radiology in 1968 which created havoc and left imaging equipment costing 400% more in a year all in an effort to improve radiation safety. Of course there was almost no difference to the patient or the staff in the end, just increased costs. What they should do is find a way to make an electronic chart that can be shared and forget all this other crap until they have that one right.
February 19th, 2009 at 7:18 pm
CCHIT is another government bureaucracy that increases the cost of healthcare by setting standards driven more by vendors rather than by physicians.
Yes standards should be adhered to by all EMR vendors. These standards are currently being set by a quasi governmental agency (CCHIT) and are paid for by big EMR vendors. These guys have a significant investment in legacy systems built on old technology.
Newer systems are nimble and quick to adapt to changing needs and don’t have a legacy heritage of 10-15 years of old software code to support. The new guys don’t have 2000 customers paying for software support but they do have software that works significantly better and meets the specific needs of physicians. Don’t penalize good software with CCHIT testing for standards submitted by old software vendors.
February 22nd, 2009 at 7:05 pm
Obviously, Obama’s doesn’t give a crap about all the transcriptionists he’ll be putting out of work with this goal of his. So much for creating more jobs and getting us out of the economic hole we’re in. Somehow, I’m not surprised.
May 23rd, 2009 at 4:50 pm
It gets even better. Hospital based physicians such as hospitalsts, ER docs, etc are EXCLUDED from the incentives in HR1. So those of us who are most likely to actually use the EMR are not even getting rewarded for doing so. Guess what? I have your EMR right here Obama.
June 15th, 2009 at 7:30 pm
I think that this is precisely the mentality that has this country where it is now. If we were capable of going to the moon when the total processing power was less then my PS3. Why should we be scared in taking such challenge? This country is full of capable individual of creating super systems (for example take a look at the Internet) The internet is full of computers and devices from different vendors, different companies and different ideas, but to you and I, it is simply the Internet. No company alone can take this task by itself. Microsoft or Apple don’t have the capacity to create then next generation of processors. They only write software and applications. Even if they were capable of doing it. It would be a good idea. Because that would create a monopoly. Every 18 months we triple the processing power, memory capacity and storage space. ISP provider are getting better and faster. We need to stop whining and get to work. Who knows maybe our kids and grand kids will thank us for it.
July 5th, 2009 at 7:32 am
I currently work with a cancer center that is ALL EMR and it is GREAT to be interfaced with companies like labcorp , and be able to facilitate a whole patient flow of the building and the services being rendered all through a computer. EMR is the way to go and all you belly rubbing cheap skates need to suck it up and get with the program.
December 16th, 2009 at 8:43 pm
I am one of the many medical transcriptionists who will lose their job thanks to government forced EMR. I love what I do and do my job well. I don’t appreciate being forced out of my job by the government. I catch mistakes on a daily basis made by physicians who get lazy in their dictation so I beg to differ on how accurate EMR will be when the same physicians are putting that info into it. After years in the field and doing a great job at what I do I am rewarded with having to look for a new career and taking a pay cut. And the job market is just so grand right now as we all know hopefully I won’t end up on the unemployment line.