Whether You Like It or Not: Change Is In the Air

It would be nice if we could rely on our experiences from the past to help us with the future. We learn how to improve our professional skills, aim to do our best, and then, things change. What may have been comfortable and appropriate at one point is suddenly inadequate and out of date. New technologies and devices force us to change our outlook.

If someone had told me 10 years ago that I should change my telephone every year and that it should be wireless, I would have thought the idea crazy. But today's developments in cell phones, PDAs, and communicators require any professional to think twice. In order to be efficient and stay connected, one needs to use the latest technologies and devices.

In the practice of medicine, big changes are coming. On the surface, changes are all about health care costs. As a physician, you will be expected more and more to know the patient's history and current status, even if she saw another specialist 2 days before. Patients, payers, and others want you to plan for, implement, and use systems that create continuity of care. A typical example is the continuity of care record (CCR). This dataset has all relevant information you'll need when you see a patient. A patient may bring it to you from the last hospital visit, another practice may fax it to you, or a colleague may e-mail it to you.

At the end of an encounter, the physician is supposed to create an updated CCR and, in case of a referral, send it to the physician to whom the patient is referred. This may sound good to you, but who is going to do the additional work? Who is going to pay for the additional costs? Who is reimbursing for the lost time?

This is where the electronic medical record (EMR) system comes in. Depending on region and specialty, 20% to 40% of physicians are using an EMR. Almost 50 EMR vendors allow you to automatically import the CCR into your system, create an updated version with just one keystroke, and export it to other providers' systems.

"Not having to act blindly is worth the several hundred dollars for an EMR lease" is a comment that I have heard quite often from physicians. Yes, EMRs can bring increased revenues, provide cost savings (particularly with transcription), increase patient safety, improve decision support, and bring better communication with other providers, payers, and patients. But the creation of continuity of care by itself is often the main catalyst for implementing an EMR.

C. Peter Waegemann is the CEO of Medical Records Institute