“We analyzed whether more computerized hospitals had lower costs of care or administration, or better quality,” the authors wrote.
The results: “Hospitals on the ‘Most Wired’ list performed no better than others on quality, costs, or administrative costs.”
Himmelstein’s study is the second this week that disputes the benefits of EMR.
Does this surprise anyone? Disappointing, of course. Right now EMRs exist as siloed, tethered pockets of data and are being utilized primarily as an expensive, poorly designed, digital cousin of the paper record kept by most physicians.
Cost, quality and improved care will follow when these systems are better designed, OPEN SOURCE, more affordable, inter-operable and connected on a nationwide level. Then the API developer community will see to it that the data can be scrubbed and analyzed in a manner that can benefit everyone.
The Orthopedic Adventure 
No surprise here. Even though EMR systems have been around for a while, there are many new vendors that have recently entered the market as the Health Care Gold rush gains speed. Like the Internet of the 90’s, many have jumped in with little health care domain or software engineering experience. These complex systems takes both types of expertise to produce a useful product. Many of these products started as prototypes then migrated to products. This is not always a bad thing if those involved with the design understand the process.I agree with Howard the most EMR are silos of data without forethought of sharing data. This is not necessarily the vendors fault since many health care facility had no desire to share “their” patient data with competition or other health facilities. As the next generation of systems is released, new requirements (as suggested above) will hopefully be satisfied. The real challenge lies with the purchaser of the EMRs to choose the systems that satisfies their organizations needs. Jeff Brandtwww.comsi.com
Speaking of Open Source, A framework for PHR The Project HealthDesign Common Platform http://www.projecthealthdesign.org/common_platform/cp_overview
As far as I’m concerned, the EMR weeding out process can’t start soon enough. My practice in Georgia covers 10 different hospitals all of whom have some semblance of EMR and NONE of which are equipt to communicate with each other very well. The idea of protecting “silos of data” is so ingrained that some times I feel it will be the next generation of Health IT professionals who see the benefits of a truly “OPEN SOURCE, affordable and inter-operable platform.Thanks for letting me vent.Onyeije
Yeah, I think it’s fair to say that many currently in-use EMR systems kind of suck. But hospitals and health care providers are a good market (i.e. have $$$) so as much as I love Open Source, I feel that this may be an important barrier. The open source alternative would need to be perceived as trustworthy/reliable enough and good enough to convince decision-makers to move away from the big/branded enterprise developers.On another note, I would say we definitely need at least a partly open source EMR, and more importantly, need open data formats/schemas/standards in order to actually start connecting and sharing data appropriately between centres.
@anniekey, Excellent points. I realize it is probably “pie in the sky” to think that hospital CEOs will embrace open source technology for hospital-based EMR any time in the near future. Generally, the way such things go is that there is intense competition by the “big/branded enterprise” types to develop large unweildy products and capture market-share before an open source alternative with a great idea elegant design and usability considerations comes along to disrupt the status quo.While we wait for that to occur, your suggestion about partially open means to exchange data on top of the current proprietary protocols would certainly be welcomed by those of us in the trenches.