EMR as a Standard of Practice?

College of Physicians and Surgeons of Alberta Messenger Leave a Comment

“At what point will the medical profession declare the use of an electronic medical record system (EMR) an expectation for all physicians to practise safe, high-quality medicine?”

This question is being asked of the College with increasing frequency, and the answer up to this point has been “At some point in the future, perhaps, but not soon.” If not soon, then when? What would be the tipping point for formalizing EMR use as an expectation?

Some arguments in favor:

  • Current estimates place EMR adoption in the 70-80% range, with other physicians using institution-based electronic patient records systems almost exclusively.
  • EMRs enhance access to diagnostic imaging reports and lab test results.
  • ePrescribing will soon enable EMR-generated prescriptions and drug dispensing events to be viewable in an EMR through integration with the Pharmaceutical Information Network.
  • EMRs facilitate quality assurance in a practice (e.g., “How many of my patients are on this drug which has just been recalled?” “How many of my patients are due for XXXX screening?”)
  • Use of registry functionality enables better chronic disease management.
  • The practice situation is just too disjointed with some physicians on paper, some on EMRs and some using both. Let’s just get everyone on EMRs and be done with it!
  • EMRs facilitate the sharing of patient information among care providers, improving the continuity of care and preventing hand-off errors.
  • Patients expect physicians to use computers in their practice. Technology has been adopted for other uses in medicine – why not for charting?

Of course, there are other perspectives:

  • Where’s the hard evidence that EMRs have saved lives or improved patient outcomes?
  • Why should use of an EMR be a Standard of Practice when use of a stethoscope isn’t?
  • Using an EMR slows me down. What about the patients I won’t be able to see because of the time I spend using one of these systems?
  • The market is too uncertain right now. We don’t know if any funding will be available, vendors are being bought up, we don’t know what AHS/PCNs/FCCs are going to do.
  • Who will help me transition from paper to an EMR? It’s too much work.
  • EMRs don’t talk to each other, so what’s the point? And they’re too clunky. They should work like a smart phone.
  • Nobody should tell me how to run my office. If it’s not a clinical or ethical issue, the College should stay out of it!

What do you think? At what point should the use of modern tools and access to/sharing of information become standards of care? Should the College be driving this issue, or be involved at all?

Please add your views online or email info@cpsa.ab.ca