Death by a Thousand (Paper) Cuts

Is your doctor putting your health at a risk?

According to a recent study published in the New England Journal of Medicine, your doctor could unintentionally be offering you and your family sub-optimal care if he/she is still using paper records to document important medical and patient information. The study found that patients in physicians' practices that used electronic medical records (EMRs) not only received better and more thorough care, but had better health outcomes than those in practices using paper records.

If this post was a Tweet, it would simply read: "EMRs = Better Health. Paper Medical Records Bad". But, dear reader, you are smart enough to know that the story is much more complicated than that... Of course, there are amazing doctors who still cling to their paper records and filing systems and there are less-than-amazing doctors that are running full patient loads on digital EMR systems. But to me, the study highlights a conundrum that has been stuck in my craw for months... It is undeniable that technological advancements have radically improved patient health outcomes over the last 50 years -- the improvement in life expectancy alone is a triumph for health care providers. For decades, doctors have been incredibly successful at adopting new technologies and integrating the new methods into their practices and we are all better off for it. But why, oh why, is the medical profession moving in slow motion joining the rest of the nation in the digitalization of their business practices?

Sure, electronic medical records that can enable seamless, instant portability of records between doctors and mitigate lethal prescription errors and reduce expenses of the medical system aren't nearly as sexy or fun for doctors as the latest robotic surgical tool. But if a doctor's primary goal is to improve public health and patient outcomes, then a rapid migration of the health care industry from the stodgy filing cabinet-filled rooms of paper files to the dynamic world of digitized medical records is perhaps one of the single most impactful actions a doctor can make to improve health care for all of us.

If your doctor is not digital yet, they probably have their reasons. Many physicians cite the cost of implementation, data security concerns and a lack of support staff as factors keeping them from making the switch. Although all these concerns are legitimate, legislation and recent developments in the healthcare IT industry have helped mitigate most of these fears.

One of the smartest elements of recent health care reforms has been the Obama administration's effort to gain 100 percent compliance with electronic records among doctors. It backed this imperative by earmarking $20 billion of the infamous 2009 stimulus bill to make the transition to EMR financially feasible for doctors. Just this year, doctors who have implemented EMR solutions have already started to receive incentive checks to cover much of the expense of going digital. Stimulus funds coupled with flexible low monthly payment options from many EMR providers have made the cost of going digital no longer an excuse to not make the switch.

Data security is valid concern by both patients and doctors, which is why EMR providers have taken important steps to ensure medical information is safe and secure. Many EMR products have built-in security measures similar to the banking industry and include features such as data encryption, secure logins and live audit feeds that track every action within the EMR database. The industry must remain vigilant when it comes to security, but the current security risks don't justify being stuck in the past. Just imagine the world if the airline/finance/retail/etc. industries used this excuse to stick to paper processes.

Currently, there are more than 230,000 physician practices in the United States, more than half of which are single doctor practices. According to a study conducted by Kalorama, these single physician practices have the lowest EMR adoption rates, at only 20.6 percent. Unlike large group practices that have dedicated office administration staff to support EMR implementation and use, single doctor practices historically have found migrating from paper to digital to be difficult and time-consuming. However, some EMR products are much more intuitive now, especially those that are easy to implement like gloStream's familiar Microsoft-based system which guarantees that doctors will be operating at full patient loads within 15 days of implementation. Because many single doctor practices are already familiar with the software, they can convert their full patient load quickly without a lot of technical and administrative support. (Full disclosure, I am on the gloStream board -- hence my passion for the topic!).

The fact that the same paper recording keeping practices used 50 years ago are still in use today by nearly half of all doctors astounds me. Admittedly, admin-related issues are the least exciting elements of any doctor's practice -- but doctors would be doing us all a favor by going digital. C'mon, docs! Make EMR integration a priority!

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