Welcome to EMR and EHR

From an Interview with Bill Gates of Microsoft. Some of his views about electronic medical records and healthcare. See complete article.

Mr. Gates was also critical of the United States government’s unwillingness to adopt a national identity card, or allow some businesses, like health care, to centralize data-keeping on individuals. “It has always come back to the idea that ‘The computer knows too much about you,’ ” he said. The United States “got off to a bad start” when it comes to using computers to keep data about its citizens, he said. Doctors are not allowed to share records about an individual patient, and virtual doctor visits are banned, he said, which “wastes a lot of money.” The United States “had better come up with a better model” for health care, he said.

I agree and disagree with Mr. Gates. We need more data sharing and more interoperability BUT confidentiality IS an important issue. Just look at how the drug tests became public about Major League Baseball Players when they were PROMISED it would be strictly confidential!!!! I don’t trust big government or big business. Question: How do you tell an attorney or politician or corporate executive are lying? Answer: Their lips or moving or their fingers are typing!

We have to make sure medical information about individuals remains confidential and remains in the control of the individual.

Everyone knows that HIPAA rules the privacy world of healthcare.  However, each state actually has their own laws governing the privacy of patient data and in particular data stored in an EMR.  I recently came across an interesting study talking about how those states which have fewer privacy laws for patient data actually have higher EMR adoption rates.  Here’s a short section from the article:

State laws in place to protect patients’ confidentiality may be causing some hospitals to be more skittish about adopting electronic medical records systems, a factor that could impede the push for the industry to go paperless, a study says.

Researchers from the Massachusetts Institute of Technology and the University of Virginia recently concluded that state privacy regulations reduce aggregate EMR adoption by between 20% and 30%. States that got rid of some of their regulations experienced a 21% gain in hospital EMR adoption rates around the years the laws changed compared with just an 11% gain in states that kept them intact, said the study.

This is really interesting, because I would have initially just called privacy laws an excuse. However, if this study holds true, then it’s more than just an excuse for why EMR adoption is low. Granted, it’s just one of many that people are using. I also think it’s worth noting that this is talking about EMR adoption in hospitals. I’m not sure most small doctors’ offices really pay enough attention to HIPAA and privacy rules for it to affect their adoption of EMR.