Why don't doctors use electronic medical records (EMR)?

Answer:
A lot of doctors do, and most would probably prefer to, but it's very expensive to set up a system. To really make it useful you have to enter all of the information you currently have in paper charts into the computer. It also has to be sophisticated software that allows you to search and enter data in multiple ways. And, it has to be secure because the database contains your patients' private health information. It can cost tens to even hundreds of thousands of dollars to set up a good system for a doctor's office.

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We are all trying...there just isn't a uniformly great system out there (need someone to invent it), most have some problems; it also takes time to learn the system, money to install, and you have to overcome years of doing it the old -fashioned way, as well as have a back up system in case of failure.

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A LOT of doctors do - but as some other people have stated, the cost can be prohibitive for a small practice. There are also a lot of choices to make; small software packages? Full EMR's with technical support? Will the EMR's in your price range interface with your labs? A lot of offices can't spare the people or the time to make the conversion. I've noticed that a lot of doctors that have been in practice for a long time are set in their ways - they like the flow in their office and aren't comfortable with change.

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Many doctor's do use electronic medical records. However, I am a HIPAA and HIM consultant and I tell all of my clients not to bother with an EHR just yet. The reason I tell them this is because the EHR's on the market today are only gearded towards HIPAA compliance.Coming from a substance abuse health information background where the regulations are more stringent than HIPAA or any state statute or administrative code, the idea of an electronic medical record in this area has always been a matter of interest to me.When people talk about privacy and security the focus is usually on HIPAA, however, as substance abuse records have their own set of federal regulations regarding confidentiality and security for the written record I have often times wondered how it would be possible for an everyday EHR program to be used in this arena. What is good for a medical provider is not what is good for a substance abuse provider. However, substance abuse providers must also implement electronic health records. Currently the issue of substance abuse and behavioral health records don’t seem to be the focus; however the information that could be housed within these types of records is absolutely necessary in the event of a medical emergency. A podiatrist could inadvertently cause serious medical issues should he inject an alcohol based injection in someone using antabuse. This information would not be housed in a “regular” medical file unless the patient informed his/her medical provider beforehand that he/she was taking the drug. 42 CFR Part 2 is so stringent that EHR companies cannot say that their software is compliant with this law. This is a huge piece of information that could be missing from a "medical" record because it is not considered "medical". You could so easily have a patient who just underwent anesthesia assisted detoxification, who gets into a car accident, is unconscious and needs emergency surgery. The surgeon could take the patient to surgery use an anesthetic that is contra indicated and kill the patient. But because this particular health infomation was substance abuse related it wasnt available in the "medical" record. It is too risky to the patients to depend on an EHR in my opinion.

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Some do, but one problem is that the "big boys" who set the rules have not agreed upon a standard format. Thus, a doctor's office might sink major money into buying a system, only to find out later that their system doesn't work with everyone else's and is therefore worthless. Another problem is that, at present, everyone expects the doctors to bear the expenses of buying and installing the systems, yet the current financial structure sends most of the financial benefits to the insurance companies and governmental regulators instead of to the doctors who bear the costs. One thing that might change the economics and promote wider adoption is a proposal to allow hospitals to foot the bill for the majority of the expenses of the doctors they work with. Many hospitals see this as desirable because it encourages doctor loyalty and standardizes the local software format.

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