Rép. : DISCUSS: Electronic medical records: bad, ugly, and dangerous?
25 Oct 2009 - 6:46pm
Alain D. M. G. ...
I've been reading up on the EHR projects in Canda for the last few years and I've also read up a bit on EHR systems in the US.
I wasn't able to read the entire article, only page three, but from that and your summary I can guess that this particular Washington Post article is a dog's breakfast of grievances and IT scandals. I've read much better stuff on EHR projects in the NY Times, and you don't have to register for it.
There are some places in the US where EHR projects have been successful and useful, two different things. However it's clear that in the US, unlike other industrialized countries, an EHR has to deal with multi-payer insurance systems, making things a lot more complicated. Among many things all those insurers require different coding schemes. One requires coding with UCD 10 the other one is still with UCD 9 , another wants CPT and UCD, another wants SNOMED etc etc. Then you have the issue of malpractice which is a lot worse in the US than in other industrialized countries. It means that you have to document any medical act in an excessive manner. You're snowed under paperwork, all the time. After that you have to code the documents.
Finally you have the decentralized nature of medical care in the US, where there is no national ministry of health (as in France say), but instead a lot of independent hospitals, most of which do not have the clout to impose their requirements on a big IT vendor, or the staff to police compliance qith all the clauses. More often than not an EHR contract in the US will be given to the lowest bidder in a very standard IT services process and there will not be much attention to the vendor's expertise in interaction design.
So yes, turning that patient record mess into a digital record is quite a nightmare, in the US.