End of the Year Review: Are EMRs Gaining Traction?
EMRs have garnered a tremendous amount of attention in the health care community. Numerous studies have illustrated the potential for increased profitability if EMRs are utilized consistently, however they have not gained significant traction in the US, and it does not appear that the industry will be adopting this solution anytime soon.
In the United States, the development of standards for EMR interoperability is at the forefront of the national health care agenda. EMRs, while an important factor in interoperability, are not a critical first step to sharing data between practicing physicians, pharmacies and hospitals. Many physicians currently have computerized practice management systems that can be used in conjunction with health information exchange (HIE), allowing for first steps in sharing patient information (i.e., lab results, public health reporting) which are necessary for timely, patient-centered and portable care. There are currently multiple competing vendors of EHR systems, each selling a software suite that in many cases is not compatible with those of their competitors. Only counting the outpatient vendors, there are more than 25 major brands currently on the market. In 2004, President Bush created the Office of the National Coordinator for Health Information Technology (ONC), originally headed by David Brailer, in order to address interoperability issues and to establish a National Health Information Network (NHIN).
Under the ONC, Regional Health Information Organizations (RHIOs) have been established in many states in order to promote the sharing of health information. Congress is currently working on legislation to increase funding to these and similar programs. The Center for Information Technology Leadership described four different categories of data structuring at which health care data exchange can take place. While it can be achieved at any level, each has different technical requirements and offers different potential for benefits realization.
The four categories are:
- Non-electronic data
- Machine transportable data
- Machine organizable data (structured messages, unstructured content)
- Machine interpretable data (structured messages, standardized content)