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"Zoom, Zoom, Zoom" (Or Whatever They'll Call It)

June 18, 2008
by Mark Hagland
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How are physician EMRs like hydrogen-powered fuel-cell cars? Both are incredibly important to our nation's future, but both are also having problems getting traction. At least that’s the similarity I’m drawing, based on recent news reports. Bear with me on this one.

First, have you heard the latest from the automotive world? On Monday, Honda Motor began producing its FCS Clarity, the world’s first hydrogen-powered fuel-cell vehicle intended for mass production. In a ceremony at a factory near Tokyo, the first assembly-line FCX Clarity rolled out to the applause of hundreds of Honda employees in coveralls. Honda will make just 200 of these futuristic vehicles over the next three years, but wants to eventually produce more of the cars.

So what’s the main problem? There are so few hydrogen filling stations that right now, for most consumers in the U.S., having such a car is not yet practical. Yet the inevitable logic of hydrogen-powered cars is absolutely there, as gas prices soar and concerns over global warming intensify. But the chicken-or-egg question hangs over the whole proposition. Average American consumers won’t buy the cars until there is a sufficiency of hydrogen power stations; but the power stations won’t appear until there’s enough demand for them.

Meanwhile, a study published in Thursday’s online edition of the New England Journal of Medicine provides new evidence of the frustratingly slow pace of EMR adoption on the part of physician practices. Respected researchers from Massachusetts GeneralHospital, WeillCornellMedicalCollege, and GeorgeWashingtonUniversity’s School of Public Health and Health Services conducted a national survey of physicians between September and March.

The researchers found that only four percent have a fully functional EMR, while 13 percent have a basic one. Meanwhile, among larger physician groups, 17 percent had a fully functional EMR, while 49 percent of physicians in larger groups (defined as being composed of at least 50 doctors) still had no EMR at all (the researchers used the term “EHR” throughout). In addition, 16 percent of physicians had purchased but not yet implemented an EMR, while another 26 percent were planning to.

The study’s authors concluded that further adoption may be enhanced by helping physicians to purchase EMRs through loans or incentive plans or by other organizations paying directly for them; and they noted that other advanced industrialized nations have followed that path. Indeed, I recently came across statistics showing countries such as Hungary and Finland having tremendously high percentages of EMR adoption compared to in this country.

All of this is quite sobering. But what’s clear is that all those parties that can help making physician practice adoption of EMRs happen will have to play their part to do so—the federal government and state governments, hospitals and health systems, health insurers, and physicians themselves. As is the case with alternatively fueled cars, everyone knows what the future must be—a landscape that includes both cleanly powered vehicles and EMRs that can improve patient care and make our healthcare system more efficient and effective—but we remain, as a nation, somewhat stymied as to exactly how to get there.

I’m reminded of the popular series of Mazda commercials (yes, I know they’re a completely different auto manufacturer) that have amused people with their “Zoom, zoom, zoom” theme. When it comes to EMRs, we need someone, or a whole bunch of someones, to put some “zoom, zoom” into our automation path, and pretty quickly, or we’ll be sitting here 20 years from now with a majority of physician practices still paper-based. And this is the 21st century?

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