Landmark EMR Studies

EMR systems have been the topic of many studies with conflicting conclusions regarding savings to the healthcare system, quality of patient care and the efficacy of computer-generated documentation. But when landmark studies examine the impact of traditional EMR on physician practices, the clear, consistent conclusion is that traditional EMRs negatively impact physicians and their practices which inhibits meaningful adoption. There are five such landmark studies performed by respected, venerable institutions:

• A recent National Research Council report states that:
  
  (i) EMRs cause inefficient workflows;
  (ii) clinicians spend more time entering data than using it;
  (iii) meaningful interoperability is almost non-existent; and
  (iv) benefits are significantly less than anticipated.
  
  This landmark study was produced by a committee of industry thought leaders from many of the most respected organizations in the world, including Harvard, MIT, Stanford, University of Pennsylvania, Brown, Google, and Intel. Committee members shadowed clinicians using traditional electronic medical records software at nationally recognized centers of medical care.
• In an enlightening New England Journal of Medicine article, renowned physicians and Harvard professors maintain that EMR technology diverts the physician’s attention from the patient and creates chart notes in a way that is seriously flawed.
• In 2008, the Congressional Budget Office released a study that was submitted as testimony before the House Ways and Means Committee. The study claims that “office-based physicians may see no benefits [from traditional EMRs] and may even suffer financial harm.”
• A U.S. government-funded study by the MGMA reported a decrease in physician productivity of up to 15% usually lasting a year or more. The study concluded that it is "difficult to establish a business case for EHR adoption."
• An exhaustive review of 195 previous studies, published in the Milbank Quarterly in December, 2009, cited reasons for the high EHR failure rate: While secondary work like audit, research, and billing may be made more efficient by EHRs, primary clinical work is often made less efficient; the larger the project, the more likely it is to fail; and EHRs do not adequately capture the messiness and unpredictability of the real world of medical practice.
  
  For more information on the studies cited, please use the following links:
  
  National Research Council report:  http://books.nap.edu/openbook.php?record_id=12572&page=R1 and click the “Sign in to download PDF book and chapters” link.
  
  New England Journal of Medicine article: (https://articleworks.cadmus.com/doc/dSoftcopy?o=708456&i=874832&c=1760334&atDownload=true) Caution: The New England Journal of Medicine is highly sensitive to the use and reproduction of their content.  The link above brings you to a site where you have to download and install a small application on your computer to view a pre-paid copy of the article.
  
  Congressional Budget Office Report: (http://www.cbo.gov/ftpdocs/95xx/doc9572/07-24-HealthIT.pdf, see page 5).
  
  MGMA Report: Gans, David N. “Off to a slow start.” MGMA Connexion, 42. Oct. 2005. Available for MGMA members at http://www.srssoft.com/pdf/MGMA_Landmark_Study.pdf).
  
  Milbank Quarterly Report: Greenhalgh, Trisha, et.al. “Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method,”
  http://srssoft.com/assets/files/Milbank-Quarterly-Report.pdf.

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