Recent statistics show only 1% of US hospitals have a full EMR system. To most this is surprising and startling information. To others it is old news. Why?
The Krafty Librarian recently posted about the Secrets of the IT Department. Go review her post for background information… I’ll wait.
Finished?
The information the Krafty Librarian posted about why IT Departments have been slow to adopt and support various technology (particularly mobile technology) can be easily applied to EMR systems.
Think about it. Many hospitals started using some form of an EMR system years ago, but years ago, IMO and review, most EMR systems were not fully developed. Yes EMR systems have been around for over a decade (4), but that does not mean the systems had all of the features needed to support a hospital with multiple departments. There are a few exceptions to this statement, and those exceptions cost a pretty penny leaving out many hospitals. So what happened? Some hospitals started using a conglomeration of systems– none of which talked to each other.
Hospitals were trying, but for the most part the technology had not caught up with hospital”s needs.
In addition to this issue, you have to remember hospitals are continuously taking care of patients. The time involved with stopping to install an entire new system is massive. Add to this the fact that there are several different systems, not one system has every feature a hospital wants, the cost involved, the inertia as Krafty mentioned (“If it ain’t broken, don’t fix it), expectations of the physicians/health professionals— all together it equals a confusing mess.
In steps the government with HITECH part of ARRA in 2009. The government, seeing the issues that developed out of Katrina and the need for all hospitals to adopt an EMR system, started working on two of the issues: funding and inertia.
Meaningful Use provides hospitals with reimbursement basically for implementing an EMR system. It even goes a step further by saying hospitals will be penalized financially if they do not implement an EMR system. Meaningful Use also provides a timeline giving many hospitals the inertia needed to start such a massive task.
Great right? So all hospitals and physician’s offices, and anyone else who deals with medical records will adopt an EMR system and have started, right? No. And they will all use the same system, right? No.
Why? Go back to Krafty’s post. If the technology involved with mobile is complicated and splintered then imagine the EMR systems. Hospitals are using different systems to best suit their needs. Good. But this currently makes it more difficult for hospitals to communicate with each other. Take a step back and look at the individual hospital environment.
Some hospitals, not all, started implementing different technology to solve niche issues. This means the hospitals have to either find a way to make these systems talk with their EMR system or disconnect all of the various systems, add new lines that will make the systems talk to each other, and then restart everything. Even if hospitals are working on paper, they still have to stop everything, determine how to get the information online, define processes for updating information (including the software), secure everything, and make it easy for health professionals.
Think of it like replacing the core of a computer system or like a heart transplant.
When something so vital is disconnected you have to be certain of how to disconnect the it, what about bypass for the time it takes to put in the new system/heart (remember you still need this vital system, or need to have a temporary replacement), will the new system/heart be rejected (process issues, software failure, systems that will not communicate), how long will it take, do you have the manpower, do you have the right tools, the funding, etc.
If you are not exhausted yet, then remember this process never stops. There will always be software updates, new research to integrate into order sets/policies/procedures, etc. Choosing the right EMR system for a hospital or physician office is vital. The wrong one could mean hours of lost labor in installing and uninstalling.
Most hospitals realize the need for EMR systems and want the systems. It is just a matter of installation and maintenance.
Krafty reminded me of why it takes so long for hospitals to integrate new technology. It is not because hospitals want to be left behind nor do they not want the best for their patients’ care. It is those three reasons Krafty listed: expectations, inertia, and funding. If the government has helped with two, will hospitals be able to overcome the first one? Will health care professionals?
Please do not get the wrong opinion with this post. I am all for hospitals adopting EMR systems and using technology in a meaningful way. I just think it is important to keep a good perspective and remember the hurdles many hospitals face. So while only 1% have full EMR systems, don’t fret yet. I feel better knowing 49% are at stage 3: nursing/clinical documentation. It is proof that hospitals are trying to do the right thing by their patients and are working towards that final stage.
References:
- Data from HIMSS AnalyticsTM Database © 2011
- Secrets of the IT Department
- HITECH
- Smaltz, Detlev and Eta Berner. The Executive’s Guide to Electronic Health Records.(2007, Health Administration Press) p.03
The post above is my, Alisha Miles, opinion and is based on reading recent articles, news resources, and other information, and does not represent a single institution but is a summary of information gathered from various resources.
